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Childhood absence epilepsy — RACP Paediatrics MCQ

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ModerateNeurologyChildhood absence epilepsyRACP Paediatrics

A 7-year-old girl is reported by her teacher to have frequent brief staring episodes lasting 5-10 seconds during which she is unresponsive. There is no fall or post-ictal confusion. She resumes activity immediately. Episodes occur multiple times daily. EEG shows 3 Hz generalised spike-and-wave discharges. What is the most likely diagnosis?

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Correct answer: A — Childhood absence epilepsy

Frequent brief staring spells (absences) with abrupt onset and offset, no post-ictal confusion, and 3 Hz generalised spike-and-wave on EEG are characteristic of childhood absence epilepsy. First-line treatment is ethosuximide or sodium valproate. Carbamazepine is contraindicated as it may worsen absences.

Reference: RCH Melbourne – 2023 – Epilepsy CPG; RACP Paediatric Curriculum – Neurology