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

An 8-year-old girl presents to the primary care clinic for evaluation of inattention for the past few months. Her parents have noted multiple episodes where she stares off into space and becomes unresponsive to her name being called. Her teacher has also noticed the same episodes, and the patient has had a noted decline in her academic performance. She has chronic difficulty falling asleep, which has been worse lately, and she sometimes only gets 7-8 hours of sleep. She takes no medication or supplements and has no other significant past medical history. Growth parameters are at the 45^th percentile. Temperature is 36.4°C (97.5°F), pulse is 80/min, respirations are 20/min, and blood pressure is 100/60 mmHg. The physical examination, including neurologic exam, is unremarkable. While obtaining the history, the patient suddenly stares straight ahead, and becomes unresponsive to auditory stimuli for 10 seconds, after which she immediately resumes the conversation. Which of the following tests should be performed to help make the diagnosis?