Seizure / Paroxysmal event

Arrhythmia
Breath-holding spell
Brief Resolved Unexplained Event
Febrile vs. non-febrile seizure
General vs. focal seizure
Status epilepticus
Syncope

  • Describe the neurophysiology of electrical and chemical signal transmission
  • Discuss the pathophysiology of seizure activity
  • Identify neurologic and non-neurologic causes of paroxysmal events
  • Apply basic principles of pharmacology in the management of seizure
  • Know that arrhythmias in children that may present with sudden collapse and identify common arrhythmias of childhood

Overview & Foundational Knowledge

Stanford Children’s Health Arrhythmias in Children

http://www.stanfordchildrens.org/en/topic/default?id=arrhythmias-in-children-90-P01764

Good website describing different types of arrhythmias in children and diagnostic testing.

Learn Pediatrics: Approach to the Child with a Seizure

http://learn.pediatrics.ubc.ca/body-systems/nervous-syste/approach-to-the-child-with-a-seizure/

Practical approach. Includes questions to ask in history, diagnosis, etiology, physical examination findings and investigations. Summary of five seizure syndromes found in children. Includes neurocutaneous disorders causing seizures in infancy.

Learn Pediatrics: Approach to Febrile Seizures

http://learn.pediatrics.ubc.ca/body-systems/nervous-syste/febrile-seizures/

Practical brief overview. Includes diagnostic criteria and table on differentiation between simple and complex febrile seizures. Covers questions to ask on history, physical examination and investigations.

Fischer WJ & Cho CS. Pediatric Syncope: Cases from the Emergency Department. Emergency Medicine Clinics of North America 2010; 28(3): 501-516.

Good table on causes of syncope; good approach to syncope in emergency department. Includes critical elements in history and physical, diagnosis. Good table on EKG findings in syncope. Includes five cases on different causes of syncope.

Wills J. Syncope. Pediatrics in Review 2000; 21(6): 201-204.

Comprehensive overview. Includes definition, etiology, differences between cardiac, non-cardiac and neurocardiac syncope, clinical aspects and management.

Learn Pediatrics: Approach to Syncope: is it cardiac or not.

http://learn.pediatrics.ubc.ca/body-systems/cardiology/approach-to-syncope-is-it-cardiac-or-not/

Clinical overview: very practical. Includes definition, common conditions, life threatening conditions and other conditions. Also covers differential diagnosis, questions to ask on history, physical examination findings, investigations. There is a good chart for investigations of syncope.

Sidhu R, Velayudam K, Barnes G. Pediatric Seizures. Pediatrics in Review 2013; 34(8): 333–342.

Overview of all types of pediatric seizures

Clinical Resources

Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower Risk infants. Tieder JS, Bonkowski JL and the Subcommittee on Apparent Life Threatening Events. AAP Clinical Practice Guideline Pediatrics. May 2016. 137(5), e1-e33.

http://pediatrics.aappublications.org/content/early/2016/04/21/peds.2016-0590

Clinical guidelines describing new terminology and approach to assessment and diagnosis.

Emergency management of the paediatric patient with generalized convulsive status epilepticus

http://www.cps.ca/en/documents/position/convulsive-status-epilepticus

http://www.cps.ca/fr/documents/position/mal-epileptique-convulsif

Canadian Paediatric Society Position Statement (2011): very practical

Febrile Seizures. Guideline for the Neurodiagnostic Evaluation of the Child With a Simple Febrile Seizure. Pediatrics 2011; 127(2) 389–394.

Clinical practice guidelines from the American Academy of Pediatrics.

Clinical Presentations