Approach to a first unprovoked seizure (pediatrics) Quiz: Ace Your Exams

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A 9-month-old infant is brought to the primary care office for a well-child visit. He has experienced global developmental delays, and his parents are concerned he may be regressing in gross motor skills. Yesterday, he had an episode while seated in his highchair, where he dropped his head forward, bent and then extended both of his arms and legs repeatedly for a few seconds. He then cried out before becoming completely relaxed for a few seconds, and then he returned to his baseline mental status and activity level. He has no other significant medical history and has not had any recent infections. He has been in his usual state of health. Growth parameters are at the 50th percentile. Temperature is 37°C (98.6°F), pulse is 120/min, respirations are 35/min, and blood pressure is 90/50 mmHg. On exam, he can sit but does not crawl. There is no meningismus. The neck is supple. Skin exam is normal. Reflexes are normal. Which of the following is most likely to be seen with further testing?

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