Childhood epilepsy: seizure types, EEG patterns and first-line drugs
RezzyChildhood epilepsy is a classic AKT topic because it's so pattern-based. Once you spot the EEG "signature," the diagnosis and treatment usually fall right into place!
I'm going to find a clear summary of the most common types you'll need to know, including those high-yield EEG patterns and the NICE-recommended first-line treatments.
That table covers some of the more specific focal syndromes, but for the UKMLA AKT, you really need to have the "Big Four" generalized seizures down cold.
I've put together a high-yield summary table for you below that matches the latest NICE guidelines (NG217) and the specific EEG patterns you'll see in exam questions.
| Seizure Type | Characteristic EEG Pattern | First-Line Drug (UK NICE) |
|---|---|---|
| Absence Seizures | ==3 Hz spike and wave== | Ethosuximide or Sodium Valproate |
| Tonic-Clonic | Generalized spike-wave | Sodium Valproate (males), Levetiracetam or Lamotrigine (females) |
| Myoclonic | Polyspike and wave | Sodium Valproate |
| Focal Seizures | Focal spikes/sharp waves | Lamotrigine or Levetiracetam |
| Infantile Spasms (West Syndrome) | ==Hypsarrhythmia== (chaotic) | Vigabatrin or Prednisolone |
| Lennox-Gastaut | Slow spike-wave (<3 Hz) | Sodium Valproate or Lamotrigine |
AKT Pro-Tip: In the UK, Sodium Valproate is now strictly controlled. For anyone under 55, it should only be started if two specialists agree there's no other option. However, for generalized seizures in males, it remains a top-tier answer. For females of childbearing potential, always look for Levetiracetam or Lamotrigine first!
That table should be your "go-to" for quick revision!
To really lock these in, I've pulled up some lessons that go into more detail on the pathophysiology and the specific clinical presentations (like the "staring into space" of absence seizures vs. the "jack-knife" spasms of West Syndrome).
📚 Childhood Epilepsy Lessons
Those lessons on Seizure Disorders and Antiepileptic Drugs are perfect for filling in the gaps, especially for the pharmacology side of things.
Just a final tip for your AKT: if you see a question about a child who is "daydreaming" or has a sudden drop in school performance, always think Absence Seizures and look for that 3 Hz spike and wave on the EEG!
Is there a specific seizure type you'd like to dive deeper into, or maybe you'd like to try a few practice questions on this?
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