Epilepsy Syndromes

Question 1

Benign childhood epilepsy with centrotemporal spikes (Benign Rolandic epilepsy)

Answer 1

Age 5y - 10y. Outgrown in adolescence
Seizure occurs during sleep or on awakening.
Focal motor seizure of the face and arm.
Abnormal movement or sensation around the face and mouth, drooling, impaired speech and swallowing.
Preserved consciousness and comprehension.
EEG : bilateral centrotemporal spikes.
Drug of choice : Carbamazepine.

Question 2

Childhood absence epilepsy

Answer 2

Age : early school years.
More in girls.
Usually resolves in adolescence,if not it will develop JME.
Brief (<15s) loss of awareness and sudden cessation of motor activities with unresponsive stare.
Accompanied by eyelid fluttering or simple automatism (lip smacking, fingers fumbling).
Provoked by hyperventilation.
EEG: 3 Hz spike and wave.
Drug of choice : Ethosuximide.

Question 3

Juvenile myoclonic epilepsy

Answer 3

Age : adolescence and young adults.
Myoclonic jerks(in morning, drop objects), generalized tonic clonic seizure, absence seizure.
Learning is Preserved.
Drug of choice : valproic acid, levetiracetam

Question 4

Infantile spasm

Answer 4

Age : 1st year of life.
Brief contractions of the neck, trunk, limbs followed by brief period of relaxation .
Occurs on awakening or going to sleep.
EEG: hypsrrhythmia
West syndrome : infantile spasm + developmental regression + hypsrrhythmia.
Drug of choice : adrenocorticotropic hormone, high dose corticosteroids, vigabatrin