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Infantile spasms — MRCPCH FOP MCQ

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HardNeurology and neurodevelopmentInfantile spasmsMRCPCH FOP

A 7-month-old girl has clusters of brief flexion movements on waking and has stopped rolling. Her parents show a video of repeated head drops and developmental regression. What is the most appropriate investigation?

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Correct answer: A — Urgent EEG arranged through paediatric neurology

Clusters of spasms with developmental regression suggest infantile spasms, and urgent EEG is needed to look for hypsarrhythmia and guide treatment. Reassurance or delayed review risks missing a time-critical epileptic encephalopathy. Lumbar puncture is not the first-line diagnostic test in this presentation. The pearl is that parental videos are often decisive in brief paroxysmal events.

Reference: NICE NG217 Epilepsies in children, young people and adults