SELF-LIMITED EPILEPSY WITH AUTONOMIC SEIZURES (SeLEAS)

	Mandatory	Alerts	Exclusionary
Seizures	Focal autonomic seizures	Seizure frequency greater than monthly
EEG	High amplitude focal or multifocal epileptiform abnormality that increases in drowsiness and sleep	Sustained focal slowing (outside the postictal period) Persistent unifocal abnormality
Age at onset		<3 years or > 8 years	<1 year or > 14 years
Development at onset		Moderate or greater impairment	Regression with spike-wave activation in sleep (consider DEE-SWAS)
Neurological exam		Abnormal exam
Imaging			Structural cause for the epilepsy
Course of illness	Remission by early to mid adolescence No regression		Regression with spike-wave activation in sleep (consider DEE-SWAS)
Are MRI or ictal EEG required for diagnosis? An MRI is not mandatory for diagnosis but should be considered in the presence of any alerts An ictal EEG is not required
Syndrome without laboratory confirmation: in resource-limited regions, an interictal EEG is required to diagnose this syndrome

NOTE Alert criteria are absent in the vast majority of patients with the syndrome, but rarely can be seen. Their presence should result in caution in diagnosing the syndrome and consideration of other conditions