A 4-year-old girl with developmental delay has daily mixed seizures: sudden drop attacks, tonic posturing of the limbs, and atypical absences. EEG shows slow spike-and-wave discharges at less than 2.5 Hz with diffuse background slowing. Which syndrome does this represent?

• A Childhood absence epilepsy
• B Lennox-Gastaut syndrome ✓
• C West syndrome
• D Dravet syndrome

Explanation

The triad of multiple refractory seizure types including tonic and atonic drops, cognitive impairment, and slow spike-and-wave discharges under 2.5 Hz defines Lennox-Gastaut syndrome, typically emerging between ages 3 and 5 years. Childhood absence epilepsy shows regular 3 Hz spike-wave with preserved development. West syndrome features spasms with hypsarrhythmia, and Dravet syndrome begins in infancy with prolonged fever-sensitive hemiclonic seizures and SCN1A mutation.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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