Lennox-Gastaut Syndrome — SCE Neurology MCQ

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ModerateEpilepsy & Seizure DisordersLennox-Gastaut SyndromeSCE Neurology

A 15-year-old boy (seen in transition clinic) has drug-resistant epilepsy with multiple seizure types including tonic, atonic ('drop attacks'), and atypical absence seizures. His EEG shows slow (<2.5 Hz) generalised spike-and-wave discharges. He has moderate intellectual disability. What epilepsy syndrome does he have?

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Correct answer: C — Lennox-Gastaut syndrome

Lennox-Gastaut syndrome (LGS) is a severe childhood-onset epileptic encephalopathy characterised by multiple seizure types (tonic, atonic, atypical absences), slow (<2.5 Hz) generalised spike-and-wave on EEG, and cognitive impairment. It is typically drug-resistant. Treatment options include valproate, lamotrigine, rufinamide, clobazam, and cannabidiol (Epidiolex — NICE TA615). Corpus callosotomy may reduce drop attacks. A: JME has myoclonic jerks and 4-6 Hz polyspike-and-wave. B: West syndrome has infantile spasms and hypsarrhythmia. D: Dravet has SCN1A mutations and fever-sensitive seizures. E: CAE has 3 Hz spike-and-wave.

Reference: NICE NG217 (2025); ILAE Syndrome Classification