Absence epilepsy EEG — SCE Neurology MCQ

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HardNeurophysiologyAbsence epilepsy EEGSCE Neurology

A 10-year-old has dozens of daily five-second staring episodes with abrupt onset and immediate recovery. Hyperventilation reliably provokes an event and EEG shows generalised symmetrical 3-Hz spike-and-wave activity. Development and neurological examination are normal. What is the diagnosis?

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Correct answer: E — Childhood absence epilepsy

The best answer is “Childhood absence epilepsy”. Typical childhood absence seizures combine frequent brief behavioural arrest, immediate recovery, hyperventilation sensitivity and generalised 3-Hz spike-wave in an otherwise normally developing child. “Focal impaired-awareness epilepsy” is less appropriate because focal seizures often last longer and may have focal semiology or postictal change “Juvenile myoclonic epilepsy” is less appropriate because juvenile myoclonic epilepsy usually begins later with morning myoclonus and faster polyspike-wave “Functional seizures” is less appropriate because a reproducible generalised electroclinical discharge is positive evidence for epilepsy “Ordinary daydreaming” is less appropriate because daydreaming is interruptible and has no ictal EEG correlate

Reference: NICE NG217: Epilepsies in children, young people and adults. https://www.nice.org.uk/guidance/ng217/chapter/Recommendations