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Absence seizures — SCE Neurology MCQ

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HardEpilepsyAbsence seizuresSCE Neurology

A 13-year-old girl presented with frequent brief staring episodes at school without falls, confusion or postictal drowsiness. On examination, hyperventilation in clinic triggered eyelid flutter and unresponsiveness for ten seconds. Initial investigations showed: EEG showed 3-Hz generalised spike-and-wave activity. What is the most likely diagnosis?

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Correct answer: B — Absence seizures

The best answer is “Absence seizures”. UK stroke guidance supports urgent vascular imaging and reperfusion selection, short-course dual antiplatelet therapy for eligible minor stroke or high-risk TIA, decompression for life-threatening swelling, and secondary prevention matched to mechanism. The alternatives “Juvenile myoclonic epilepsy”, “Focal impaired-awareness epilepsy”, “Eyelid myoclonia with absences”, “Daydreaming without an electroclinical seizure” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: National Clinical Guideline for Stroke: acute care: https://www.strokeguideline.org/chapter/acute-care/