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Childhood absence epilepsy — RACP Paediatrics MCQ

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ModerateNeurology and neurodevelopmentChildhood absence epilepsyRACP Paediatrics

A 7-year-old has frequent brief episodes of staring at school. During episodes she stops mid-sentence, blinks and resumes immediately; hyperventilation in clinic provokes a typical event. EEG shows generalised 3 Hz spike-and-wave discharges. What is the most appropriate management?

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Correct answer: C — Start ethosuximide after epilepsy specialist confirmation

Childhood absence epilepsy is characterised by brief provoked absences and 3 Hz spike-and-wave; ethosuximide is standard first-line therapy when absence seizures are the main seizure type. Carbamazepine may worsen generalised epilepsies. The pearl is that hyperventilation is a useful bedside activation test for absence seizures.

Reference: Therapeutic Guidelines (eTG): Neurology; AMH Children's Dosing Companion