# Peculiar Clinical Manifestation in a Child With Self‐Limited Epilepsy With Autonomic Seizures (SeLEAS) Presenting in an All‐Four Position: A Case Report

## TL;DR

A child with SeLEAS epilepsy had an unusual all-four position presentation, highlighting the need to recognize diverse symptoms for proper diagnosis.

## Contribution

This case report documents a previously unreported clinical presentation of SeLEAS epilepsy in a child.

## Key findings

- The child presented in an all-four position, an atypical initial sign of SeLEAS.
- Recognizing diverse SeLEAS manifestations is crucial to prevent misdiagnosis.
- The case emphasizes the importance of timely and appropriate management of SeLEAS.

## Abstract

Self‐limited epilepsy with autonomic seizures (SeLEAS), previously known as Panayiotopoulos syndrome, presents with focal autonomic seizures in early childhood and is a self‐limited epilepsy syndrome. Previous articles have described the various manifestations of this syndrome, which are predominantly autonomic symptoms. In this article, we describe a child with an unusual initial presentation of SeLEAS. She was found resting on her elbows on all fours, a symptom that has not been previously reported and is different from the usually reported clinical presentations. This case underscores the importance of recognizing diverse clinical manifestations of SeLEAS to avoid misdiagnosis so that timely, appropriate management can be initiated.