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Lennox-Gastaut Syndrome — RACP Paediatrics MCQ

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ModerateNeurology & DevelopmentLennox-Gastaut SyndromeRACP Paediatrics

A 4-year-old boy presents with a 6-month history of 'drop attacks' where he suddenly falls forward. These episodes occur many times per day. His EEG shows generalised 2–2.5 Hz slow spike-and-wave discharges. Cognitive regression is noted. What is the most likely diagnosis?

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Correct answer: C — Lennox-Gastaut syndrome

Lennox-Gastaut syndrome is characterised by multiple seizure types (including tonic, atonic 'drop attacks', and atypical absences), slow spike-and-wave (1.5–2.5 Hz) on EEG, and cognitive impairment/regression. Onset is typically between 1–8 years. It is a severe epileptic encephalopathy with a poor prognosis. West syndrome (infantile spasms) has a peak onset at 4–7 months.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Epileptic Encephalopathies