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Childhood absence epilepsy — MRCPCH FOP MCQ

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ModerateNeurology and neurodevelopmentChildhood absence epilepsyMRCPCH FOP

A 6-year-old girl has frequent brief episodes of staring at school. They last 10 seconds, interrupt speech, have eyelid fluttering and she resumes activity immediately afterwards. What is the most likely diagnosis?

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Correct answer: D — Childhood absence epilepsy

Brief frequent staring spells with abrupt onset and offset, eyelid fluttering and no post-ictal phase suggest childhood absence epilepsy. Daydreaming is usually interruptible and less abrupt. Focal impaired-awareness seizures tend to last longer and often have post-ictal confusion or automatisms. The pearl is that hyperventilation during examination may provoke absence seizures.

Reference: NICE NG217 Epilepsies; BNFc ethosuximide