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EEG in absence epilepsy — SCE Neurology MCQ

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HardNeurological InvestigationsEEG in absence epilepsySCE Neurology

A 14-year-old has brief, frequent eyelid jerks with upward eye deviation, consistently triggered by eye closure and bright flickering light. EEG shows generalised polyspike-and-wave discharges immediately after eye closure. What syndrome best fits?

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Correct answer: D — Epilepsy with eyelid myoclonia and eye-closure sensitivity

The best answer is “Epilepsy with eyelid myoclonia and eye-closure sensitivity”. Eye-closure sensitivity, photosensitivity and generalised discharges accompanying eyelid myoclonia define this generalised epilepsy syndrome. “Childhood absence epilepsy” can be reasonable in another presentation, but it does not account for the defining feature here. “Focal occipital epilepsy” can be reasonable in another presentation, but it does not account for the defining feature here. “Juvenile myoclonic epilepsy without eyelid myoclonia” can be reasonable in another presentation, but it does not account for the defining feature here. “Photosensitive syncope” can be reasonable in another presentation, but it does not account for the defining feature here.

Reference: NICE NG217 epilepsy recommendations: https://www.nice.org.uk/guidance/ng217/chapter/Recommendations