A 7-year-old girl has multiple daily episodes of abrupt cessation of activity with blank staring lasting 10 seconds and immediate return to normal awareness. EEG shows generalized 3 Hz spike-and-wave discharges provoked by hyperventilation. First-line drug of choice is:
- A Phenytoin
- B Ethosuximide ✓
- C Carbamazepine
- D Gabapentin
Correct answer: B. Ethosuximide
Explanation
Childhood absence epilepsy with classic 3 Hz spike-and-wave bursts is treated first with ethosuximide, which blocks thalamic T-type calcium channels; valproate is preferred if generalized tonic-clonic seizures coexist. Carbamazepine, phenytoin, and gabapentin are sodium-channel or synaptic agents that can aggravate absence seizures, making them actively harmful here.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.