Which progression of seizures is considered rare?

The progression of seizures considered rare in the context provided is from Rolandic seizures to absence seizures. Rolandic seizures, also known as benign epilepsy with centrotemporal spikes, typically occur in children and are characterized by focal motor activity, often during sleep. They tend to remit by the teenage years and generally do not progress to other seizure types.

Absence seizures, in contrast, often present as short episodes of staring or loss of awareness and are a distinct epilepsy type often associated with childhood-onset absence epilepsy. The transition from Rolandic seizures to absence seizures is not commonly observed in clinical practice, making this progression an unusual combination.

In contrast, the other options listed represent more commonly observed seizure progression patterns in various epilepsy syndromes. West syndrome can evolve into Lennox-Gastaut syndrome, which is well-documented and involves multiple seizure types, including tonic and atonic seizures. Absence seizures can occasionally progress to generalized tonic-clonic seizures, particularly in individuals with generalized epilepsy syndromes. Lastly, complex partial seizures can generalize, leading to generalized seizures, which is also a recognized phenomenon in epilepsy. Thus, the options provided highlight typical pathways, reinforcing why the progression from Rolandic to absence seizures is identified as rare.