A 9-year-old boy has multiple brief episodes daily of staring with cessation of activity lasting about 10 seconds, followed immediately by return to full awareness. EEG shows generalized 3 Hz spike-and-wave discharges. Which drug is the initial treatment of choice?
- A Ethosuximide ✓
- B Phenytoin
- C Carbamazepine
- D Gabapentin
Correct answer: A. Ethosuximide
Explanation
This is childhood absence epilepsy. Ethosuximide is the preferred initial therapy because it blocks T-type calcium channels in thalamic neurons and controls absences without the cognitive and cosmetic adverse effects of valproate. Carbamazepine, phenytoin, and gabapentin are sodium-channel or other agents that can worsen absence seizures, which is the key fact that eliminates them.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.