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Infantile spasms — RACP Paediatrics MCQ

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HardNeurology and neurodevelopmentInfantile spasmsRACP Paediatrics

A 6-month-old has clusters of sudden flexor spasms on waking, with developmental plateauing over the past month. Examination shows poor visual attention and axial hypotonia. What is the most appropriate investigation?

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Correct answer: A — Urgent EEG looking for hypsarrhythmia

Clusters of flexor spasms with developmental regression suggest infantile spasms, requiring urgent EEG to identify hypsarrhythmia or an epileptic encephalopathy pattern. Delay risks further developmental harm. A parent video is helpful, but it should support urgent assessment rather than replace it.

Reference: RCH Seizures guideline; RACP Knowledge Guides