Case of Childhood Absence Epilepsy with Focal Spikes

Childhood absence epilepsy is a common generalized epilepsy syndrome characterized by childhood onset of frequent sporadic absence seizures. During onset, the electroencephalogram exhibits bilateral, symmetric, and synchronous discharges of approximately 3 Hz of generalized spike-and-wave complexes. Focal spikes are often found in children with focal epilepsy but are not common in absence epilepsy.

In the case patient, focal spikes were observed during active onset of absence epilepsy and at 5 years after the first hospital visit, at which time absence epilepsy was controlled and medication was withdrawn without focal seizure attack in the interim.

This case demonstrates that focal spikes associated with childhood absence epilepsy do not require specific treatment in the absence of focal seizures.