Early-onset absence epilepsy aggravated by valproic acid: a video-EEG report

Area of Science:

• Neurology
• Pediatric Epilepsy

Background:

• Early-onset absence epilepsy, defined by absence seizures before age 4, is a diverse group of conditions.
• Seizures beginning in the first year of life are exceptionally uncommon.

Observation:

• A case study of an 11-month-old boy experiencing absence seizures.
• Seizure frequency escalated after initiating valproic acid (VPA) therapy.
• Seizures significantly improved after discontinuing VPA, with no identifiable cause like toxicity or deficiency.

Findings:

• Levetiracetam effectively controlled absence seizures in this patient.
• The patient experienced a benign course regarding both seizure control and neuropsychological development.
• The electroclinical presentation and outcome were similar to Childhood Absence Epilepsy (CAE), suggesting a continuum within Idiopathic Generalized Epilepsy (IGE).

Implications:

• This case highlights a rare presentation of early-onset absence epilepsy with paradoxical worsening on valproic acid.
• Levetiracetam appears to be a safe and effective treatment option for such cases.
• Findings support the concept of early-onset absence epilepsies being part of a broader spectrum of idiopathic generalized epilepsies.