Department of Neurology

Daily staring spells

Q: Could someone help please we are in need of URGENT information regarding what form of epilepsy our son has, if he has epilepsy at all.

Steven is 11 years 6 months old. Just before his 11th birthday it was reported to us (from school) that Steven was often tired in class. Steven was tested for diabetes but this was negative. Steven was referred to the local hospital and had an EEG, CAT scan and a further sleep deprived EEG. No conclusive evidence of epilepsy showed up.

Stevens symptoms are:

(This only happens in the mornings.)

Steven normally wakes up fine. Has breakfast, gets dressed etc. About 30 minutes to 1 hour after getting up Steven starts going into and out of staring spells (blank looks) but still responsive if spoken to. Some mornings he comes out of them by stimulation re: playing board games/playing on the computer. Other times he goes into a dreamy state and feels confused. He does not remember what has happened to him. We normally send him back to bed for one hour and wakes up fine. Some times we find giving him coke in the morning helps. If Steven is left he becomes very non-responsive, pale and does not know where, who, or what anything is.

Steven was given Tegretol on 15 December 1996, 5 mls twice daily. This did not stop the seizures (?) so his dose was increased to 10 mls twice daily on 1 January 1997. On 13 January 1997 we took Steven off Tegretol as his seizures (?) were becoming more frequent, obviously not the right drug.

 Can you help please... IS THIS EPILEPSY AND IF SO WHAT FORM AND IF NOT WHAT IS IT?


A: Staring episodes are often seizures, although it is unlikely your son could turn on a video game and play it during a seizure. It is often difficult to distinguish behavioral problems from epileptic seizures, and different seizure types need different types of medication. Since he has spells almost daily, a definitive diagnosis may be obtained by perfoming video-EEG monitoring to correlate his episodes with his brain activity. Once you have a firm diagnosis, i.e., whether it is epilepsy or not, you can then pursue a solid course of therapy. If his spells are seizures, the monitoring will also help to identify what type of epilepsy he has, and will assist in selecting the most appropriate therapy.

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