Quiz on Childhood Epilepsies

• Q.1 2 month old boy with uneventful birth history started having very frequent focal seizures arising from different regions of the brain. Prolonged VEEG showed migration of the ictal rhythm from one focus to another in some of the prolonged events. MRI brain and metabolic studies were normal. Anomalies in which of the below mentioned genes might lead to this clinical syndrome?

  • A) KCNT1

  • B) CDKL5

  • C) SLC2A1

  • D) MECP2

• Q.2 Which seizure type is the most characteristic of Lennox Gastaut syndrome

  • A) Atonic seizures

  • B) Myoclonic seizures

  • C) Tonic seizures

  • D) Atypical absence seizures

• Q.3 4 year old boy presented with significant global developmental delay with complete absence of speech, facial dysmorphism and myoclonic seizures. His EEG showed the following pattern almost throughout the recording (figure 1).

  The most likely diagnosis is

  • A) West syndrome

  • B) Angelman syndrome

  • C) Doose syndrome

  • D) Prader Willi syndrome

• Q.4 1 year old boy with uneventful birth history presented with myoclonic seizures and episodes of vacant stare, mostly in the morning hours along with mild developmental delay. His metabolic parameters were normal except for markedly reduced CSF sugar. He was on phenytoin, phenobarbitone, levetiracetam and clobazam. Which one of these, you would like to withdraw

  • A) Phenytoin

  • B) Phenobarbitone

  • C) Levetiracetam

  • D) Clobazam

• Q.5 One month old baby girl presented with episodes of tonic posturing, cyanosis and frequent myoclonic jerks. Grandmother noticed that almost all of these episodes occurred while the baby was awake and was put in the supine position. The attacks were relieved by flexing the legs. She was started on clonazepam by her pediatrician with significant improvement in the frequency and severity of these events. The most likely diagnosis is

  • A) Shuddering spells

  • B) Breath holding spells

  • C) Jitteriness

  • D) Hyperekplexia

• Q.6 Which one of these newer generation antiepileptic drugs is planned to be withdrawn from the market by the parent company? It is mechanistically related to a childhood epileptic syndrome.

  • A) Rufinamide

  • B) Peramapanel

  • C) Ezogabine

  • D) Valrocemide

• Q.7 6 year old developmentally normal girl presented with recent regression in expressive speech and reading. She had 2 episodes of nonfebrile seizures one year back and was started on an antiepileptic drug. She was completely seizure free afterwards. Her awake and sleep EEGs are given below (figure 2 & 3 respectively).

  Which one of the following might most probably be the antiepileptic drug she is taking now?

  • A) Carbamazepine

  • B) Clobazam

  • C) Levetiracetam

  • D) Lamotrigine

• Q.8 NEMO trial failed to demonstrate the efficacy of this drug in neonatal seizures

  • A) Phenobarbitone

  • B) Pyridoxine

  • C) Topiramate

  • D) Bumetanide

• Q.9 This non pharmacologic intervention primarily developed for weight reduction in obese persons has been found to be useful in many drug resistant childhood epilepsies

  • A) Acupressure

  • B) Atkins diet

  • C) Hyperbaric Oxygen

  • D) Electromagnetic therapy

• Q.10 3 month old boy presented with significant floppiness, weakness and seizures. MRI brain showed thick, flat gyri diffusely. Which of the following blood investigations most probably may point towards the diagnosis

  • A) Elevated lactate

  • B) High S. CPK

  • C) Low Hemoglobin

  • D) High S. Uric Acid