Absence, focal and generalised epilepsies — branching viva

Outpatient clinic: a seven-year-old girl with dozens of brief staring spells a day, unresponsive during the spells, immediate recovery, no memory, normal development, and an electroencephalogram showing three-per-second generalised spike-and-wave. The examiner asks: classify the seizure, name the syndrome, give the first-choice medicine and the trial behind it — then branches to the carbamazepine-worsens-absence rule, the developmental surveillance, and finally to the same child re-presenting at fifteen with morning jerks and a generalised tonic-clonic seizure that reframes the syndrome and invokes the valproate rule.