Pseudo Hypsarrhythmia: An Early Marker of Angelman Syndrome

An 18-month-old girl presented with concerns of language delay and recurrent seizures from the age of 12 months. She was the second born to a nonconsanguineous couple and had an uneventful perinatal period. Her development was age-appropriate except in the language domain. She recognized words for common items like “cup,” and listened when spoken to, but her expressive language was restricted to gurgling sounds and babbling. Her seizures were brief, generalized tonic, and were associated with a short period of postictal drowsiness. Grinding of teeth was also noted. The seizure frequency had gradually increased to 4–5 episodes per week over the last 6 months, and the parents had noticed the appearance of generalized tremulousness and lack of any new milestones. At 18 months of age, she was able to take a few steps by holding on to furniture, pick up small objects, and wave bye-bye. Her speech was unclear, she used gestures to communicate and was still babbling