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pres.layout = "LAYOUT_16x9";
pres.title = "Types of Seizures in the Paediatric Age Group";
pres.author = "Orris Medical Education";

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// ═══════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE
// ═══════════════════════════════════════════════════════════════════
titleSlide(
  "Types of Seizures in the\nPaediatric Age Group",
  "Classification • Clinical Features • Epilepsy Syndromes • Management"
);

// ═══════════════════════════════════════════════════════════════════
// SLIDE 2 — OUTLINE
// ═══════════════════════════════════════════════════════════════════
{
  let s = contentSlide("Contents", C.teal);
  const items = [
    "1.  Definition & Epidemiology",
    "2.  ILAE 2017 Classification Framework",
    "3.  Focal Onset Seizures",
    "4.  Generalised Onset Seizures",
    "5.  Unknown Onset Seizures",
    "6.  Age-Based Seizure Frequency Chart",
    "7.  Febrile Seizures (Simple vs Complex)",
    "8.  Paediatric Epilepsy Syndromes by Age",
    "9.  Neonatal Seizures",
    "10. Status Epilepticus",
    "11. Investigations Table",
    "12. Antiseizure Medications by Seizure Type",
    "13. Non-Pharmacological Management",
    "14. Key Take-Home Points",
  ];
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// ═══════════════════════════════════════════════════════════════════
// SLIDE 3 — DEFINITION & EPIDEMIOLOGY
// ═══════════════════════════════════════════════════════════════════
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    { text:"SEIZURE — Definition\n", options:{ bold:true, color:C.navy } },
    { text:"A transient occurrence of signs/symptoms due to abnormal, excessive or synchronous neuronal activity in the brain (ILAE 2005).", options:{ color:C.darkgray } },
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    { text:"Key Epidemiological Facts\n", options:{ bold:true, color:C.navy, breakLine:true } },
    { text:"• Febrile seizures affect 2–5% of children (most common seizure type in childhood)\n", options:{ breakLine:true } },
    { text:"• Peak incidence: 3 months – 6 years\n", options:{ breakLine:true } },
    { text:"• Epilepsy prevalence: ~1% in children\n", options:{ breakLine:true } },
    { text:"• ~30–40% risk of febrile seizure recurrence\n", options:{ breakLine:true } },
    { text:"• Absence seizures: peak onset 4–10 years", options:{} },
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    ["Single event","≥2 unprovoked seizures >24h apart OR 1 unprovoked seizure with high recurrence risk (≥60%)"],
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    ["Does not require treatment if provoked","Usually requires antiseizure medication"],
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// ═══════════════════════════════════════════════════════════════════
// SLIDE 4 — ILAE 2017 CLASSIFICATION FRAMEWORK
// ═══════════════════════════════════════════════════════════════════
{
  let s = contentSlide("ILAE 2017 Operational Classification of Seizure Types", C.teal);
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    { label:"FOCAL ONSET", x:0.3, col:C.teal, items:["Aware (Simple Partial)","Impaired Awareness (Complex Partial)","Motor: automatisms, atonic, clonic, epileptic spasms, hyperkinetic, myoclonic, tonic","Non-motor: autonomic, behaviour arrest, cognitive, emotional, sensory","Focal to Bilateral Tonic-Clonic"] },
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    { label:"UNKNOWN ONSET", x:6.8, col:C.orange, items:["Motor: tonic-clonic, epileptic spasms","Non-motor: behaviour arrest","Unclassified"] },
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}

// ═══════════════════════════════════════════════════════════════════
// SLIDE 5 — FOCAL ONSET SEIZURES (DETAILED)
// ═══════════════════════════════════════════════════════════════════
{
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    ["Focal Aware\n(Simple Partial)", "Intact", "Motor: Jacksonian march\nSensory: tingling, visual aura\nAutonomic: tachycardia, pallor\nPsychic: déjà vu, fear", "Localised discharge in contralateral cortex. Duration <2 min"],
    ["Focal Impaired Awareness\n(Complex Partial)", "Impaired", "Staring, automatisms (lip-smacking, hand-wringing), post-ictal confusion. Most common in temporal lobe origin.", "Unilateral temporal or frontotemporal focus. Duration 1–3 min"],
    ["Focal to Bilateral\nTonic-Clonic", "Initially intact → lost", "Starts focal, generalises. Todd's palsy (post-ictal hemiparesis) may follow.", "Focal discharge → bilateral spread"],
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    {type:"Focal Aware (Simple Partial)", aware:"Intact", feat:"Motor: Jacksonian march • Sensory: tingling, visual aura • Autonomic: tachycardia, pallor • Psychic: déjà vu, fear", eeg:"Localised discharge, contralateral cortex. Duration <2 min"},
    {type:"Focal Impaired Awareness (Complex Partial)", aware:"Impaired", feat:"Staring, automatisms (lip-smacking, hand-wringing), post-ictal confusion. Temporal lobe most common.", eeg:"Unilateral temporal or frontotemporal focus. Duration 1–3 min"},
    {type:"Focal → Bilateral Tonic-Clonic", aware:"Initially intact → lost", feat:"Starts focal, generalises. Todd's palsy (post-ictal hemiparesis) may follow.", eeg:"Focal discharge → bilateral spread"},
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// ═══════════════════════════════════════════════════════════════════
// SLIDE 6 — GENERALISED ONSET SEIZURES
// ═══════════════════════════════════════════════════════════════════
{
  let s = contentSlide("Generalised Onset Seizures — Clinical Features", C.navy);
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    {type:"Tonic-Clonic\n(Grand Mal)", feat:"Loss of consciousness, tonic stiffening → clonic jerking → post-ictal confusion. Duration 1–3 min.", eeg:"Generalised spike-and-wave or poly-spike during ictus", note:"Most dramatic seizure type; common in JME"},
    {type:"Absence\n(Petit Mal)", feat:"Brief staring (3–30 sec), abrupt onset/offset, no post-ictal state. Automatisms: eyelid blinking, lip-smacking. Hyperventilation can provoke.", eeg:"3 Hz generalised spike-and-wave during ictus; normal background", note:"Onset 4–10 yrs; ethosuximide is first-line"},
    {type:"Myoclonic", feat:"Brief, sudden muscle jerks, usually bilateral. Often on awakening. No loss of consciousness in isolated myoclonus.", eeg:"Poly-spike or spike-and-wave. Photo-sensitive in some.", note:"Seen in JME, Dravet, Lennox-Gastaut"},
    {type:"Tonic", feat:"Sustained stiffening (arms/legs), often nocturnal, may fall. Duration 2–20 sec.", eeg:"Fast activity or low-voltage fast discharge", note:"Common in Lennox-Gastaut"},
    {type:"Atonic (Drop Attack)", feat:"Sudden loss of muscle tone → head nod or fall. Risk of injury.", eeg:"Spike-wave or polyspike-wave burst", note:"Common in Lennox-Gastaut; vagus nerve stimulator can help"},
    {type:"Epileptic Spasms\n(Infantile Spasms)", feat:"Sudden flexion/extension of trunk and limbs in clusters on awakening. Peak onset 4–6 months.", eeg:"Hypsarrhythmia (interictal); high-amplitude chaotic activity", note:"West syndrome; ACTH/steroids first-line"},
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// ═══════════════════════════════════════════════════════════════════
// SLIDE 7 — AGE-DISTRIBUTION CHART (bar chart)
// ═══════════════════════════════════════════════════════════════════
{
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    { name:"Simple Partial",  labels:["0-14","15-34","35-64",">65"], values:[11,10,8,13] },
    { name:"Gen. Tonic-Clonic", labels:["0-14","15-34","35-64",">65"], values:[19,25,25,27] },
    { name:"Absence",        labels:["0-14","15-34","35-64",">65"], values:[13,0,0,0] },
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}

// ═══════════════════════════════════════════════════════════════════
// SLIDE 8 — FEBRILE SEIZURES
// ═══════════════════════════════════════════════════════════════════
{
  let s = contentSlide("Febrile Seizures", C.orange);
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        "Generalised tonic-clonic",
        "Duration < 15 minutes",
        "Single episode per febrile illness",
        "No focal features",
        "Full recovery within 1 hour",
        "Age 6 months – 5 years",
        "No neurological deficits",
        "Benign; reassure parents",
        "Risk of epilepsy: ~1–2% (same as general population)",
      ]
    },
    {
      title:"COMPLEX Febrile Seizure", color:C.red, x:5.0, items:[
        "ANY of the following:",
        "• Duration > 15 minutes (febrile SE)",
        "• Focal features (Jacksonian, Todd's palsy)",
        "• >1 seizure in same illness / 24 hours",
        "Risk of subsequent epilepsy: 6–10%",
        "Requires further workup (EEG, MRI if focal)",
        "Consider LP if meningitis suspected",
        "Diazepam prophylaxis controversial",
        "Mesial temporal sclerosis: rare long-term risk",
      ]
    },
  ];
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}

// ═══════════════════════════════════════════════════════════════════
// SLIDE 9 — FEBRILE SEIZURE RISK TABLE
// ═══════════════════════════════════════════════════════════════════
{
  let s = contentSlide("Febrile Seizures — Risk Factors & Recurrence", C.orange);
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  s.addText("RISK FACTORS FOR RECURRENCE",{x:0.3,y:0.85,w:4.5,h:0.38,fontSize:12,bold:true,color:C.white,fontFace:"Calibri",align:"center",valign:"middle",margin:0});
  const rec=[
    ["Risk Factor","Significance"],
    ["Age at onset < 1 year","Strongest predictor"],
    ["Family history of febrile seizures","1st degree relative"],
    ["Daycare attendance","Increased febrile illness exposure"],
    ["Complex febrile seizure","Higher recurrence & epilepsy risk"],
    ["Low fever at time of seizure","Earlier seizure threshold"],
  ];
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  const epi=[
    ["Population","Risk (%)"],
    ["General population","~1%"],
    ["After simple febrile seizure","~1–2%"],
    ["After complex febrile seizure","~6–10%"],
    ["Pre-existing neurodevelopmental abnormality","~33%"],
    ["Multiple complex features (≥2 risk factors)","Up to 49%"],
  ];
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  // Bottom note
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  s.addText([
    {text:"Immediate Management of Febrile Seizure\n",options:{bold:true,color:C.navy,breakLine:true}},
    {text:"• Lay child on side (recovery position) • Protect airway • Time the seizure • Do NOT insert objects in mouth\n",options:{breakLine:true}},
    {text:"• If >5 min: rectal diazepam (>2 yrs) | intranasal midazolam | IV lorazepam\n",options:{breakLine:true}},
    {text:"• Investigate for and treat underlying cause of fever (LP if meningitis suspected)",options:{}},
  ],{x:0.4,y:4.0,w:9.2,h:1.05,fontSize:10.5,fontFace:"Calibri",color:C.darkgray});
  s.addText("Source: Bradley & Daroff | Tintinalli's Emergency Medicine | Harriet Lane 23e",{x:0.3,y:5.28,w:9.4,h:0.2,fontSize:8,color:"888888",fontFace:"Calibri",italic:true});
}

// ═══════════════════════════════════════════════════════════════════
// SLIDE 10 — PAEDIATRIC EPILEPSY SYNDROMES TABLE
// ═══════════════════════════════════════════════════════════════════
{
  let s = contentSlide("Paediatric Epilepsy Syndromes — by Age of Onset", C.navy);
  s.addShape(pres.ShapeType.rect,{x:0.2,y:0.85,w:9.6,h:0.38,fill:{color:C.navy}});
  ["Syndrome","Age Onset","Seizure Type","EEG","Treatment"].forEach((h,i)=>{
    const xpos=[0.25,2.45,3.5,5.35,7.35];
    const ws=[2.15,1.0,1.8,1.95,2.35];
    s.addText(h,{x:xpos[i],y:0.87,w:ws[i],h:0.34,fontSize:10.5,bold:true,color:C.white,fontFace:"Calibri",valign:"middle"});
  });
  const syndromes = [
    {name:"Neonatal Seizures",age:"0–28 days",sz:"Subtle (bicycling, apnea), myoclonic, clonic, tonic",eeg:"Burst suppression (severe forms)",tx:"Treat cause; phenobarb, levetiracetam, pyridoxine"},
    {name:"Ohtahara Syndrome\n(EIEE)",age:"Neonatal",sz:"Tonic spasms in clusters",eeg:"Burst suppression",tx:"Pyridoxine trial; ASMs; ketogenic diet"},
    {name:"West Syndrome\n(Infantile Spasms)",age:"3–12 months\n(peak 4–6 mo)",sz:"Epileptic spasms in clusters; flexor/extensor/mixed",eeg:"Hypsarrhythmia",tx:"ACTH, prednisolone, vigabatrin (TSC)"},
    {name:"Dravet Syndrome",age:"1st year\n(febrile trigger)",sz:"Prolonged febrile hemiclonic; myoclonic; focal",eeg:"Nonspecific; PHR often present",tx:"Clobazam, valproate, stiripentol, fenfluramine, cannabidiol"},
    {name:"Lennox-Gastaut\nSyndrome",age:"1–8 years",sz:"Tonic (nocturnal), atonic (drop), atypical absence",eeg:"Slow spike-wave <2.5 Hz; fast activity",tx:"VPA, clobazam, lamotrigine, rufinamide, felbamate, ketogenic diet"},
    {name:"Childhood Absence\nEpilepsy (CAE)",age:"4–10 years",sz:"Brief absences; hyperventilation provokes",eeg:"3 Hz spike-wave; normal background",tx:"Ethosuximide (1st line), VPA, lamotrigine"},
    {name:"BECTS (Rolandic\nEpilepsy)",age:"3–13 years\n(peak 7–10)",sz:"Focal clonic (face/arm), nocturnal GTCS, centrotemporal",eeg:"Centrotemporal sharp waves; normal background",tx:"Often self-limiting; carbamazepine, levetiracetam"},
    {name:"Juvenile Myoclonic\nEpilepsy (JME)",age:"Adolescence\n(12–18 yrs)",sz:"Morning myoclonus, GTCS, absence; photic-sensitive",eeg:"4–6 Hz poly-spike-wave; sleep-deprived EEG",tx:"Valproate, lamotrigine, levetiracetam; lifelong Rx"},
    {name:"Panayiotopoulos\nSyndrome",age:"3–6 years",sz:"Autonomic (vomiting, pallor); occipital with eye deviation",eeg:"Occipital spikes; shifting multifocal",tx:"Often not treated; resolves by puberty"},
  ];
  syndromes.forEach((r,i)=>{
    const bg = i%2===0 ? C.white : C.ltgray;
    const y0 = 1.25 + i*0.455;
    s.addShape(pres.ShapeType.rect,{x:0.2,y:y0,w:9.6,h:0.44,fill:{color:bg}});
    const xpos=[0.25,2.45,3.5,5.35,7.35];
    const ws=[2.15,1.0,1.8,1.95,2.35];
    const vals=[r.name,r.age,r.sz,r.eeg,r.tx];
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      s.addText(v,{x:xpos[j],y:y0+0.02,w:ws[j],h:0.4,fontSize:8.5,fontFace:"Calibri",color:j===0?C.navy:C.darkgray,bold:j===0,valign:"middle"});
    });
  });
  s.addText("BECTS = Benign Epilepsy with Centrotemporal Spikes | TSC = Tuberous Sclerosis Complex | ASM = Antiseizure Medication | VPA = Valproic Acid\nSource: Harriet Lane Handbook 23e (Table 20.4) | Bradley & Daroff | Adams & Victor 12e",{
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  });
}

// ═══════════════════════════════════════════════════════════════════
// SLIDE 11 — NEONATAL SEIZURES (SPECIAL SLIDE)
// ═══════════════════════════════════════════════════════════════════
{
  let s = contentSlide("Neonatal Seizures — Special Considerations", C.purple);
  s.addText("Occur within first 28 days of life. Often subtle and difficult to diagnose clinically.", {
    x:0.3,y:0.85,w:9.4,h:0.35,fontSize:12,color:C.darkgray,fontFace:"Calibri",italic:true,
  });
  // Seizure types box
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  s.addText("CLINICAL TYPES",{x:0.3,y:1.25,w:4.5,h:0.38,fontSize:12,bold:true,color:C.white,fontFace:"Calibri",align:"center",valign:"middle",margin:0});
  const nt = [
    ["Type","Features"],
    ["Subtle (most common)","Eye blinking/deviation, chewing, bicycling, apnea, autonomic changes"],
    ["Clonic","Rhythmic jerking, focal or multifocal"],
    ["Tonic","Sustained extension/flexion; focal > generalised"],
    ["Myoclonic","Random jerks; multifocal"],
  ];
  s.addTable(nt,{x:0.3,y:1.63,w:4.5,h:2.2,fontSize:10,fontFace:"Calibri",colW:[1.5,3.0],border:{type:"solid",color:"AAAAAA",pt:0.5},fill:{color:C.white},rowH:0.44});

  // Causes box
  s.addShape(pres.ShapeType.rect,{x:5.1,y:1.25,w:4.6,h:0.38,fill:{color:C.navy}});
  s.addText("CAUSES (VITAMIN mnemonic)",{x:5.1,y:1.25,w:4.6,h:0.38,fontSize:12,bold:true,color:C.white,fontFace:"Calibri",align:"center",valign:"middle",margin:0});
  const causes=[
    "V — Vascular (HIE, haemorrhage, stroke)",
    "I  — Infection (meningitis, encephalitis)",
    "T  — Trauma (birth injury)",
    "A  — Anomaly (brain malformation)",
    "M  — Metabolic (hypoglycaemia, hypocalcaemia, hypomagnesaemia, hyponatraemia)",
    "I  — Inborn errors of metabolism (pyridoxine-dep. epilepsy, PKU)",
    "N  — Neonatal-specific (benign neonatal seizures, 5th day fits)",
  ];
  const cbullets = causes.map((t,i)=>({text:t,options:{breakLine:i<causes.length-1}}));
  s.addShape(pres.ShapeType.rect,{x:5.1,y:1.63,w:4.6,h:2.2,fill:{color:"F8F0FF"},line:{color:C.purple,width:1}});
  s.addText(cbullets,{x:5.15,y:1.67,w:4.5,h:2.12,fontSize:10,fontFace:"Calibri",color:C.darkgray,lineSpacingMultiple:1.3});

  // Vs jitteriness
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  s.addText([
    {text:"Seizure vs Jitteriness in Neonates\n",options:{bold:true,color:C.navy,breakLine:true}},
    {text:"Seizure: Associated with autonomic changes (tachycardia, apnea), not stimulus-sensitive, cannot be suppressed by flexing the limb\n",options:{breakLine:true}},
    {text:"Jitteriness: No eye deviation, stimulus-sensitive, suppressed by flexing limb, no autonomic changes",options:{}},
  ],{x:0.4,y:3.95,w:9.2,h:1.1,fontSize:10.5,fontFace:"Calibri",color:C.darkgray});
  s.addText("Source: Harriet Lane Handbook 23e (Table 20.4) | Adams & Victor's Neurology 12e",{x:0.3,y:5.28,w:9.4,h:0.2,fontSize:8,color:"888888",fontFace:"Calibri",italic:true});
}

// ═══════════════════════════════════════════════════════════════════
// SLIDE 12 — STATUS EPILEPTICUS
// ═══════════════════════════════════════════════════════════════════
{
  let s = contentSlide("Status Epilepticus in Children", C.red);
  // Definition boxes
  s.addShape(pres.ShapeType.rect,{x:0.3,y:0.85,w:9.4,h:0.6,fill:{color:"FFF0F0"},line:{color:C.red,width:1.5}});
  s.addText([
    {text:"DEFINITION: ",options:{bold:true,color:C.red}},
    {text:"Seizure lasting ≥5 minutes OR ≥2 discrete seizures without return to baseline in between (operational definition)\nTraditional definition: >30 minutes of continuous seizure activity",options:{color:C.darkgray}},
  ],{x:0.35,y:0.87,w:9.3,h:0.56,fontSize:11,fontFace:"Calibri",valign:"middle"});

  // Timeline management
  s.addShape(pres.ShapeType.rect,{x:0.3,y:1.52,w:9.4,h:0.36,fill:{color:C.navy}});
  s.addText("STEPWISE MANAGEMENT TIMELINE",{x:0.3,y:1.52,w:9.4,h:0.36,fontSize:12,bold:true,color:C.white,fontFace:"Calibri",align:"center",valign:"middle",margin:0});
  const steps = [
    {t:"0–5 min",c:C.green,label:"STABILISE",detail:"Airway, Breathing, Circulation\nPosition lateral; O₂; IV/IO access; glucose check"},
    {t:"5–20 min\n1st Line",c:C.teal,label:"BENZODIAZEPINES",detail:"Lorazepam 0.1 mg/kg IV (max 4 mg)\nOR Diazepam rectal 0.5 mg/kg\nOR Midazolam IN/buccal 0.2 mg/kg\nRepeat once if no response at 5–10 min"},
    {t:"20–40 min\n2nd Line",c:C.orange,label:"2ND LINE ASMs",detail:"Phenytoin/Fosphenytoin 20 mg/kg IV\nOR Valproate 40 mg/kg IV (avoid in metabolic disease)\nOR Levetiracetam 60 mg/kg IV\nOR Phenobarbitone 20 mg/kg IV"},
    {t:">40 min\n3rd Line",c:C.red,label:"RSI / ANAESTHESIA",detail:"RSI: Midazolam/Propofol/Thiopentone infusion\nICU admission; continuous EEG monitoring\nLacosamide, ketamine also used"},
  ];
  steps.forEach((st,i)=>{
    const x = 0.3 + i*2.42;
    s.addShape(pres.ShapeType.rect,{x,y:1.9,w:2.28,h:0.38,fill:{color:st.c}});
    s.addText(st.t,{x,y:1.9,w:2.28,h:0.38,fontSize:9,bold:true,color:C.white,fontFace:"Calibri",align:"center",valign:"middle",margin:0});
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    s.addText(st.label,{x,y:2.28,w:2.28,h:0.32,fontSize:9.5,bold:true,color:st.c,fontFace:"Calibri",align:"center",valign:"middle",margin:0});
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    s.addText(st.detail,{x:x+0.05,y:2.65,w:2.18,h:2.43,fontSize:9,fontFace:"Calibri",color:C.darkgray,valign:"top",lineSpacingMultiple:1.25});
  });
  s.addText("Source: Harriet Lane Handbook 23e | Tintinalli's Emergency Medicine | Bradley & Daroff",{x:0.3,y:5.28,w:9.4,h:0.2,fontSize:8,color:"888888",fontFace:"Calibri",italic:true});
}

// ═══════════════════════════════════════════════════════════════════
// SLIDE 13 — INVESTIGATIONS TABLE
// ═══════════════════════════════════════════════════════════════════
{
  let s = contentSlide("Investigations in Paediatric Seizures", C.teal);
  s.addShape(pres.ShapeType.rect,{x:0.2,y:0.85,w:9.6,h:0.38,fill:{color:C.teal}});
  ["Investigation","Indication","What to Look For"].forEach((h,i)=>{
    const xp=[0.25,3.05,6.15]; const ws=[2.75,3.05,3.5];
    s.addText(h,{x:xp[i],y:0.87,w:ws[i],h:0.34,fontSize:11,bold:true,color:C.white,fontFace:"Calibri",valign:"middle"});
  });
  const inv=[
    ["Blood Glucose","ALL first seizures (immediate)","Hypoglycaemia (<2.6 mmol/L); treat immediately"],
    ["Electrolytes (Na, Ca, Mg)","Neonates, infants, first unprovoked seizure","Hypo/hypernatraemia, hypocalcaemia, hypomagnesaemia"],
    ["FBC, CRP, cultures","Suspected CNS infection or febrile seizure with meningism","Sepsis screen; guide LP decision"],
    ["Lumbar Puncture (LP)","Febrile seizure <12 months with no clear source; suspected meningitis","Cells, protein, glucose, culture, viral PCR, TB where endemic"],
    ["EEG","All unprovoked seizures; epilepsy workup","Seizure focus, hypsarrhythmia, 3 Hz spike-wave, burst suppression"],
    ["MRI Brain","Focal seizure, neurological deficit, epilepsy >2 seizures, abnormal EEG","Cortical dysplasia, hippocampal sclerosis, tumour, malformation"],
    ["CT Brain","Acute head injury, no MRI available, acute haemorrhage suspected","Haemorrhage, herniation, acute structural lesion"],
    ["Metabolic screen","Neonatal seizures, suspected IEM, developmental regression","Lactate, ammonia, amino acids, urine organic acids, VLCFA"],
    ["Genetic testing","Dravet (SCN1A), Angelman, TSC, ring chromosome","Confirm genetic syndrome; guide targeted therapy"],
    ["Pyridoxine trial","Neonatal/infantile refractory seizure","Give 100 mg IV pyridoxine; observe for response on EEG"],
  ];
  inv.forEach((r,i)=>{
    const bg = i%2===0?C.white:C.ltgray;
    const y0=1.25+i*0.4;
    s.addShape(pres.ShapeType.rect,{x:0.2,y:y0,w:9.6,h:0.38,fill:{color:bg}});
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    });
  });
  s.addText("IEM = Inborn errors of metabolism | TSC = Tuberous Sclerosis Complex | VLCFA = Very long chain fatty acids | PHR = Photoparoxysmal response",{
    x:0.2,y:5.27,w:9.6,h:0.2,fontSize:7.5,color:"888888",fontFace:"Calibri",italic:true,
  });
}

// ═══════════════════════════════════════════════════════════════════
// SLIDE 14 — ANTISEIZURE MEDICATIONS
// ═══════════════════════════════════════════════════════════════════
{
  let s = contentSlide("Antiseizure Medications by Seizure Type", C.navy);
  s.addShape(pres.ShapeType.rect,{x:0.2,y:0.85,w:9.6,h:0.38,fill:{color:C.navy}});
  ["Seizure/Syndrome","1st Line","2nd Line","AVOID"].forEach((h,i)=>{
    const xp=[0.25,2.95,5.75,8.25]; const ws=[2.65,2.75,2.45,1.5];
    s.addText(h,{x:xp[i],y:0.87,w:ws[i],h:0.34,fontSize:11,bold:true,color:C.white,fontFace:"Calibri",valign:"middle"});
  });
  const asm=[
    ["Focal Onset Seizures","Carbamazepine, Oxcarbazepine, Lamotrigine, Levetiracetam","Topiramate, Zonisamide, Lacosamide, Brivaracetam","—"],
    ["Generalised Tonic-Clonic","Valproic acid, Levetiracetam, Lamotrigine","Topiramate, Zonisamide","Carbamazepine (may worsen absence/myoclonic)"],
    ["Childhood Absence Epilepsy","Ethosuximide (most effective; no GTCS cover), Valproate","Lamotrigine","Carbamazepine, Oxcarbazepine, Tiagabine"],
    ["Juvenile Myoclonic\nEpilepsy","Valproate (most effective), Levetiracetam, Lamotrigine","Zonisamide, Topiramate, Clobazam","Carbamazepine, Oxcarbazepine (exacerbate myoclonus)"],
    ["Infantile Spasms\n(West Syndrome)","ACTH or Prednisolone (hormonal Rx), Vigabatrin (for TSC)","Ketogenic diet, Valproate, Topiramate","—"],
    ["Lennox-Gastaut\nSyndrome","Valproate, Clobazam, Lamotrigine","Rufinamide, Felbamate, Topiramate, Cannabidiol","Tiagabine; use caution with carbamazepine"],
    ["Dravet Syndrome","Clobazam + Valproate, Stiripentol, Fenfluramine, Cannabidiol","Topiramate, Zonisamide","Sodium channel blockers (Carbamazepine, Phenytoin, Lamotrigine)"],
    ["Neonatal Seizures","Phenobarbitone 20 mg/kg IV, Levetiracetam","Phenytoin/Fosphenytoin, Pyridoxine trial","—"],
    ["Febrile SE (>5 min)","Lorazepam IV OR Midazolam IN/buccal","Diazepam rectal if no IV access","—"],
  ];
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  });
  s.addText("Source: Harriet Lane Handbook 23e | Goodman & Gilman | Bradley & Daroff | Katzung's Basic & Clinical Pharmacology 16e",{
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  });
}

// ═══════════════════════════════════════════════════════════════════
// SLIDE 15 — NON-PHARMACOLOGICAL MANAGEMENT
// ═══════════════════════════════════════════════════════════════════
{
  let s = contentSlide("Non-Pharmacological Management", C.teal);
  const boxes = [
    {title:"Ketogenic Diet", color:C.amber, x:0.3, y:0.9, w:4.5, h:2.1, items:[
      "High-fat, low-carbohydrate diet",
      "Ratio 4:1 (fat : protein+carb)",
      "Used for drug-refractory epilepsy",
      "Effective in: Lennox-Gastaut, GLUT1 deficiency, Dravet",
      "Monitor: ketones, metabolic acidosis, lipids, growth",
      "Side effects: GI upset, kidney stones, decreased growth, hyperlipidaemia",
      "Avoid dextrose IV fluids",
    ]},
    {title:"Surgical Options", color:C.navy, x:5.1, y:0.9, w:4.6, h:2.1, items:[
      "Vagus Nerve Stimulation (VNS): adjunct therapy",
      "Deep Brain Stimulation (DBS)",
      "Responsive Neurostimulation (RNS): not yet approved in children",
      "Focal Resection: temporal lobectomy, focal cortical resection",
      "Hemispherectomy: hemispheric seizure origin",
      "Corpus Callosotomy: for atonic/tonic seizures in LGS",
      "Candidate: identified focus, failed 2+ ASMs, non-eloquent cortex",
    ]},
    {title:"Lifestyle & Trigger Avoidance", color:C.green, x:0.3, y:3.1, w:4.5, h:1.85, items:[
      "Regular sleep schedule (triggers JME especially)",
      "Avoid alcohol (adolescents with JME)",
      "Sunglasses for photosensitive epilepsy",
      "Swim/bath only supervised",
      "Inform school; seizure action plan",
      "No driving until seizure-free",
    ]},
    {title:"Rescue Medication Plans", color:C.purple, x:5.1, y:3.1, w:4.6, h:1.85, items:[
      "Diazepam rectal: children >2 years, seizure >5 min",
      "Midazolam IN spray: approved >12 years",
      "Buccal midazolam: widely used off-label for children",
      "Train parents/caregivers in administration",
      "Written seizure action plan for school/home",
    ]},
  ];
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}

// ═══════════════════════════════════════════════════════════════════
// SLIDE 16 — KEY TAKE-HOME POINTS
// ═══════════════════════════════════════════════════════════════════
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  const points = [
    "Febrile seizures are the MOST COMMON seizure type in children (2–5%); most are benign simple febrile seizures",
    "Use ILAE 2017 classification: Focal Onset | Generalised Onset | Unknown Onset — determine onset BEFORE choosing treatment",
    "Complex febrile seizures (>15 min, focal, or multiple in 24h) carry a 6–10% risk of later epilepsy",
    "West syndrome (hypsarrhythmia on EEG): ACTH/prednisolone is first-line — early treatment improves neurodevelopmental outcome",
    "Lennox-Gastaut features: multiple seizure types (tonic, atonic, atypical absence) + slow spike-wave + cognitive impairment",
    "Childhood Absence Epilepsy: ethosuximide is first-line (superior efficacy); hyperventilation provokes absence on EEG",
    "Dravet syndrome: AVOID sodium channel blockers (carbamazepine, phenytoin, lamotrigine) — they WORSEN seizures",
    "Status Epilepticus: treat at 5 min with benzodiazepine; 2nd line at 20 min; RSI at 40 min",
    "Neonatal seizures: Exclude and treat metabolic causes first (glucose, Ca, Mg, pyridoxine) before ASMs",
    "JME requires LIFELONG antiseizure medication — very high relapse rate on withdrawal",
  ];
  points.forEach((p,i)=>{
    const yp = 0.82 + i*0.44;
    s.addShape(pres.ShapeType.rect,{x:0.35,y:yp,w:0.32,h:0.32,fill:{color:C.amber},line:{color:C.amber}});
    s.addText(String(i+1),{x:0.35,y:yp,w:0.32,h:0.32,fontSize:11,bold:true,color:C.navy,fontFace:"Calibri",align:"center",valign:"middle",margin:0});
    s.addText(p,{x:0.75,y:yp,w:9.0,h:0.38,fontSize:10.5,color:C.white,fontFace:"Calibri",valign:"middle"});
  });
  s.addText("Sources: PP Ghai (Paediatric textbook principles) | Harriet Lane Handbook 23e | Bradley & Daroff's Neurology | Adams & Victor 12e | Tintinalli's EM | Goodman & Gilman | Katzung 16e",{
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  });
}

// ═══════════════════════════════════════════════════════════════════
// WRITE FILE
// ═══════════════════════════════════════════════════════════════════
pres.writeFile({ fileName: "/home/daytona/workspace/pediatric-seizures/Paediatric_Seizures.pptx" })
  .then(() => console.log("✅ Presentation saved!"))
  .catch(e => { console.error("❌ Error:", e); process.exit(1); });