Related Experiment Videos
Absence seizures: valproate or ethosuximide?
Insights
Ethosuximide (ESM) and valproate (VPA) effectively treat absence seizures in children, with 80.8% achieving complete seizure reduction. VPA showed superiority in specific cases, and drug combinations are beneficial for refractory seizures.
Area of Science:
- Pediatric Neurology
- Epileptology
Background:
- Absence seizures are a common epilepsy syndrome in children.
- Treatment efficacy varies, necessitating evaluation of different antiepileptic drugs.
Purpose of the Study:
- To retrospectively analyze the treatment outcomes of absence seizures in children.
- To compare the effectiveness of ethosuximide (ESM) and valproate (VPA).
Main Methods:
- Retrospective analysis of 47 children with absence seizures.
- Evaluation of treatment with ESM and VPA, including combination therapy.
- Assessment of seizure frequency reduction and adverse events.
Main Results:
- 80.8% of children achieved 100% seizure reduction.
- ESM and VPA were effective as first-line treatments.
- Valproate (VPA) demonstrated superiority in treating absence seizures with EEG polyspikes or absence status.
Conclusions:
- Both ESM and VPA are essential for managing absence seizures in children.
- Combination therapy with ESM and VPA is beneficial for refractory cases.
- Valproate (VPA) is particularly effective for specific seizure types within absence epilepsy.
Abstract:
A series of 47 children with absence seizures was analysed retrospectively. Fourteen of these children also had other types of seizures, and four had repeated episodes of absence status. The age at onset of absence seizures ranged from 1 1/2 to 13 years (mean, 7.9 years). The mean follow-up was 5.5 years. Ethosuximide (ESM) was used as the drug of first choice in 43 children, and valproate (VPA) was used first in 4 children; 15 of the patients later received VPA alone or in combination with ESM. A 100% reduction in seizure frequency was achieved in 38 children (80.8%). Of these, 23 has received ESM (21 ESM; 2 ESM + nitrazepam) and 15 had received VPA (6 VPA; 9 VPA + ESM). Of the latter group, 11 children had had an unsuccessful trial of ESM. VPA was superior in the treatment of children who had EEG polyspikes or absence status. A seizure reduction of 50% to 75% was achieved in 7 children (14.9%). Two patients (4.3%) had refractory seizures. A transient Stevens-Johnson syndrome occurred in a patient treated with ESM. Other side effects were mild and transient. Both ESM and VPA are needed in the treatment of absence seizures. In refractory cases, the combination of these drugs appears to be beneficial.