Atypical absences in Lennox-Gastaut syndrome (video-EEG)

This 8-year-old boy with learning difficulties and Lennox-Gastaut syndrome has numerous atypical absence seizures as well as atonic and tonic seizures that are intractable to any appropriate antiepileptic medication. The video shows lengthy episodes of generalized spike-wave discharges that are asymmetrical with marked variation in the intradischarge frequency from 1 to 3 Hz. These are associated with very mild impairment of consciousness, nystagmus-like rhythmic oculoclonic movements while he is able to respond to questions and continues his predischarge activity. An atonic seizure with fall happens in the middle of one of the discharges. Time between vertical lines = 1 sec. (From: Panayiotopoulos CP. The epilepsies: seizures, syndromes and management. Oxford: Bladon Medical Publishing, 2005.)