Forced normalization induced by ethosuximide therapy in a patient with intractable myoclonic epilepsy

Forced normalization (FN) is a well known phenomenon of acute psychosis accompanying seizure control. An 11-year-old boy with intractable myoclonic epilepsy and severe psychomotor delay experienced FN during medication of ethosuximide. Although his myoclonic seizures were completely controlled, behavioral changes, more of the manic type, became evident. EEG during this phenomenon showed almost normal findings. Generally, withdrawal of anti-epileptic drugs in patients with FN is still controversial and much debated. We could conclude that the physician should judge comprehensively the treatment considering the more favorable situation for the patient and the family.