A 7-year-old has absence seizures characterized by brief (5-10 second) staring spells with eyelid flickering occurring 15-20 times daily, triggered by hyperventilation. EEG shows 3 Hz spike-and-wave discharges. The antiepileptic drug of choice for this specific syndrome is:
- A Carbamazepine
- B Phenobarbitone
- C Phenytoin
- D Ethosuximide ✓
Explanation
Childhood absence epilepsy (CAE) with 3 Hz spike-and-wave on EEG is treated with ethosuximide as the drug of first choice, which targets T-type calcium channels in thalamic neurons. Ethosuximide is specifically effective for absence seizures and has an excellent side-effect profile in children. Sodium valproate is a second option (also effective but more systemic side effects). Carbamazepine and phenytoin can paradoxically worsen absence seizures and are contraindicated. Lamotrigine is an alternative second-line agent. Phenobarbitone has sedative side effects and is not first-line for absence.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.