Long-term effectiveness of ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy.

Hee Hwang, Hunmin Kim, Seung Hyo Kim, Se Hee Kim, Byung Chan Lim, Jong-Hee Chae, Ji Eun Choi, Ki Joong Kim, Yong Seung Hwang

Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea. neuroandy@korea.com

Brain & development 2012 May

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We performed this study to evaluate the long-term efficacy and tolerability of ethosuximide (ESX), valproic acid (VPA), and lamotrigine (LTG) as initial monotherapies for patients with newly diagnosed childhood absence epilepsy. We retrospectively reviewed the medical records of 128 patients (45 boys and 83 girls) diagnosed with childhood absence epilepsy at the Seoul National University Hospital. The diagnosis was based on the criteria proposed by Panayiotopoulos in 2005. We measured the seizure-free rate and the retention rate observed during 2 years of treatment. Follow-up electroencephalography (EEG), any reported adverse events, and reasons for antiepileptic drug (AED) discontinuation were reviewed. The seizure-free rate of ESX (84%) was significantly higher than that of VPA (62%) and LTG (53%) at 3 months. The seizure-free rate of ESX (90%) was significantly higher than that of LTG (63%) at 6 months. After 9 months, there was no significant difference in seizure-free rate among the three groups. There were no significant differences among the three groups in terms of normalization of EEG at 12 months (ESX, 77%; VPA, 83%; and LTG, 64%), retention rate throughout the whole treatment period, and adverse-event rates (ESX, 25%; VPA, 29%; and LTG, 14%). This study suggests that ESX, VPA, and LTG are equally effective in the long-term treatment of newly diagnosed CAE patients. However, the onset of efficacy was faster for ESX compared with VPA or LTG. Efficacy, tolerability, and adverse event profiles should be carefully considered when selecting AEDs to treat individual patients with CAE. Copyright © 2011 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Citation

Hee Hwang, Hunmin Kim, Seung Hyo Kim, Se Hee Kim, Byung Chan Lim, Jong-Hee Chae, Ji Eun Choi, Ki Joong Kim, Yong Seung Hwang. Long-term effectiveness of ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy. Brain & development. 2012 May;34(5):344-8