An 8-year-old boy has frequent brief episodes of staring with cessation of activity lasting about 10 seconds, several times daily. Hyperventilation during EEG recording reproduces the attacks. The EEG shows generalised 3 Hz spike-and-wave discharges. Which drug is the first choice?

• A Gabapentin
• B Carbamazepine
• C Phenytoin
• D Ethosuximide ✓

Explanation

This is childhood absence epilepsy: hyperventilation provokes the spells and the EEG shows 3 Hz generalised spike-and-wave. Ethosuximide is the first-line drug for absence seizures because it selectively blocks T-type calcium channels in thalamic neurons. Carbamazepine, phenytoin, and gabapentin are sodium-channel or alpha-2-delta acting agents that can worsen absence seizures and are contraindicated here.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.