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Question
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A 10 years boy woke up with Twitching of right face and right hand, was dysarthric for few seconds, underwent EEG shown below.. What would be the next step?
Explanation
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BRE/ BECTS/ Self-limited epilepsy with centrotemporal spikes (SeLECTS)<br>Onset between 3 and 13 years<br>Unilateral facial motor seizures associated with somatosensory symptoms<br>Common in sleep<br>Spontaneous recovery < 16 years<br>No CNS lesions<br>Normal BGA & normal sleep structures<br>Centrotemporal spikes are the hallmark<br>Broad, diphasic, high-voltage (100-300) spikes, followed by a slow wave<br><br>Atypical BRE:<br>Early age of onset (<2yrs)<br>Day time seizures as well<br>Todds paresis<br>Prolonged Seizures, Status epilepticus<br>Atypical spike morphology & location(posterior)<br>Central spikes without temporal spikes<br>Abnormal background<br>Slow spike-wave focus<br>Synchronous foci
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Reference
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P.Parisi et al, Epilepsy and behaviour 75(2017)165-9
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Option 1
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Is Correct (Option 1):
Reassure the family
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Option 2
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Is Correct (Option 2):
Advice for MRI epilepsy protocol
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Option 3
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Is Correct (Option 3):
Suggest genetic study for ADNFLE
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Option 4
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Is Correct (Option 4):
CSF evaluation for HSV PCR
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