a. A detailed developmental history should be taken.You want to ask about family history although this is more difficult in this case since he was adopted.
b. Benign Rolandic epilepsy of childhood or simple partial seizures.
c. Electroencephalogram (EEG).
In this case, the EEG showed left-sided centrotemporal spikes. This appearance is typical for benign Rolandic epilepsy of childhood and can also be bilateral.
A sleep EEG often intensif|es the spike activity. Further investigations like neuro-imaging are not indicated
because of the diagnostic nature of the EEG and the absence of any neurological abnormalities on clinical
examination.
d. The best treatment is not to treat! The condition is
benign and because the seizures usually occur during
sleep or on waking, it is well tolerated. If the seizures
are interfering with schooling or quality of life, carbamazepine or valproate may be used.The age of onset
is between 3 and 13 years.
e. Prognosis is excellent. Seizures commonly stop at the
age of 12 years and the EEG normalizes several years
later. There is no increased risk of seizure development
in later life. This is a genetic disorder transmitted
as an autosomal dominant trait. Forty percent of close relatives have a history of febrile convulsions
or epilepsy.
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