Lennox Gustaut Syndrome: A Case Report

Background and literature review Lennox-Gastaut syndrome (LGS) is one of the catastrophic childhood epilepsies. It is defined by a triad of symptoms: Multiple types of generalized seizures, which are difficult to control. - Slowness of intellectual growth, often accompanied by mental retardation and behavioral problems. - A specific electroencephalogram (EEG) pattern called a slow spike-and-wave pattern (less than 2.5 Hz), which is present when the child is awake. The Lennox-Gastaut syndrome is uncommon but it is very serious. The mortality rate ranges from 3 % to 7 %. Often the prevalence of LGS is described as a percentage of childhood epilepsy. The reported prevalence of LGS varies between studies but it is in the range of 3�10 % of childhood epilepsy, and is more common in males than females. A twenty two year old male with longstanding seizure disorder presented to the casualty with multiple episodes of generalized seizures lasting more than 30 min. Seizures were well controlled with injectable benzodiazepine. The patient had a past history of Dengue viral encephalitis at the age of 13years after which he developed the seizure episode with in between episodes of absence seizures for which the child was on regular dual antiepileptic medication. The child was mute and deaf since then with developmental retardation including intellectual abilitites and autism. On investigating the MRI showed atrophy of bilateral temporal lobes and posterior inferior aspect of bilateral parietal lobes as well as dilatation of bilateral lateral ventricle. EEG showed multifocal epileptiform abnormalities along with moderate degree of diffuse electrophysiological dysfunction over frontal regions bilaterally. Intermittent polymorphic 0.5-1 Hz, slow waves were noted over both hemispheres, more over the frontal area. Relatively symmetrical and synchronous 3-4Hz activity over both the posterior head regions were noted and was thus diagnosed as Lennox Gustaut Syndrome and was treated accordingly.