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Childhood absence epilepsy — USMLE Step 3 MCQ

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HardPediatricsChildhood absence epilepsyUSMLE Step 3

A 5-year-old boy has recurrent episodes of staring lasting 10 seconds. During episodes he stops speaking and blinks rapidly, then immediately resumes activity. Hyperventilation in clinic provokes an event. EEG shows generalized 3-Hz spike-and-wave discharges. Which of the following is the most appropriate next step in management?

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Correct answer: B — Ethosuximide

Childhood absence epilepsy presents with brief staring spells provoked by hyperventilation and 3-Hz spike-and-wave on EEG. Ethosuximide is first-line when absence seizures are the main seizure type.

Reference: American Academy of Neurology epilepsy treatment guidance