Ethosuximide (ESM) is used commonly as a first-line therapy for typical absence seizures occurring in primary generalized epilepsy syndromes. However, atypical absence is more common in the developmentally disabled population. Although ESM may be effective against atypical absence, the common association with other seizures (e.g., atonic, myoclonic, generalized tonic-clonic) that do not respond to ESM renders it a less-than-optimal choice for treating such patients.
Although ESM usually is considered a benign treatment for absence seizures in primary generalized epilepsies, it can cause:
The controversial entity of “forced normalization”45 has been invoked as a potential explanation for ESM-related behavioral abnormalities, in which ESM-induced “normalization” of the EEG recording results in a paradoxical behavioral abnormality.46
Reviewed and revised June 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.
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