A 7-year-old boy has multiple brief daily episodes of staring with cessation of activity lasting about 10 seconds each, sometimes with eyelid fluttering, without postictal confusion. EEG shows generalized 3 Hz spike-and-wave discharges provoked by hyperventilation. First-line drug of choice:
- A Phenytoin
- B Carbamazepine
- C Ethosuximide ✓
- D Gabapentin
Correct answer: C. Ethosuximide
Explanation
Childhood absence epilepsy shows the classic 3 Hz generalized spike-and-wave pattern, and ethosuximide is the preferred initial agent because it blocks T-type calcium channels in thalamic neurons. Valproate or lamotrigine are alternatives when generalised tonic-clonic seizures coexist. Carbamazepine, phenytoin and gabapentin can worsen absences, so recognising the syndrome before choosing a drug is essential.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.