View source for Lennox Gastaut Syndrome

==Background==
* Severe seizures in childhood
* Presentation before eight years of age, most commonly between three and five years of age
* Many cases evolve into Lennox Gastaut from other epilepsy syndromes, particularly [[West Syndrome (Infantile Spasm)]]

==Clinics==
* Mixture of seizure types
** Tonic
** Tonic-clonic
** Atonic (drop attacks)
** Myoclonic
** atypical absences
* Brief tonic seizures of seconds to 1 minute.
* The seizures can cause falls.
* Eyelid retraction, staring, mydriasis, and apnea are commonly associated
* The seizures are frequent
* Mental retardation before seizure onset in 20-60%

==EEG== 
* [[Spike slow wave complex]] superimposed on an abnormal, slow background.
* The [[Spike slow wave complex]] and [[Sharp wave slow wave complex]] are generalized at a frequency of 1.5 to 2.5 Hz (slow), usually with the highest amplitude frontal.
* Transient and shifting asymmetries are frequent
* Non-REM sleep increases the discharges. In REM sleep the discharges decreases.
* Hyperventilation or photic stimulation does not trigger the discharges.
<br /> 
'''Ictal EEG'''<br />  
* '''Tonic seizure:''' typically fast rhythmic discarges of 10 – 20 Hz,  increasing in amplitude. 
* '''Myoclonic seizures:''' bursts of arrhythmic, multiple spike-wave or irregular spike-wave activity
* '''Atypical absence seizures:''' Slow (<2.5 Hz) and often asymmetric and irregular spike-and-wave activity

==Treatment==
* No drug is highly effective
* Valproic acid, lamotrigine, topiramate, rufinamide, felbamate, and clobazam can be effective
* Carbamazepine can worsen the drop attacks


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'''''Lennox gastaut in a 3 years and 10 months old boy (source) with multiple spike and slow waves and a slow basic rhythm'''''
[[File:Lennox_gastaut_in_a_3_years_and_10_months_old_boy_(source)_EEGpedia.png|border|none|1200px|left]]


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