Abstracts

Rationale: Ethosuximide (ESX), valproic acid (VPA), and lamotrigine (LTG) are used as antiepileptic drug (AED) for childhood absence epilepsy (CAE). In Korea, domestic pharmaceutical companies have not produced ESX for a problem of the charge for the medicine since 2010. Accordingly, doctors in Korea had to change the medicine to LTG or VPA to treat patients. We performed this study to compare the efficacty of monotherapy and polytherapy of LTG and VPA for CAE. Methods: Medical records of 12 patients (7 girls, 5 boys) diagnosed with CAE at Bucheon St. mary's hospital between 2009 and 2011 were reviewed retrospectively. Results: Among them, four patients (33%) had been treated with ESX at treatment onset, six patients (50%) had been treated with LTG, and the remaining two patients (17%) were first treated with VPA. All of patients treated with ESX achieved seizure freedom. But ESX was replaced by LTG for ESX treatment group for the halt in production. One patient (25%) of them achieved seizure freedom, and the rest three patients (75%) experienced more than 50% reduction of seizure frequency after four weeks of initial titration. VPA was added on for the rest three patients, and then all of them achieved seizure freedom. One of two patients treated with VPA achieved seizure freedom and another experienced more than 50% reduction of seizure frequency after four weeks of initial titration. LTG was added on for another patient, and then she achieved seizure freedom. One patient (17%) of patients treated with LTG achieved seizure freedom, and the rest five patients (83%) experienced more than 50% reduction of seizure frequency after four weeks of initial titration. But one patient who achieved seizure freedom with LTG had severe headache, then we reduced dose of LTG and add on with VPA. VPA was added on for the rest five patients, and then all of them achieved seizure freedom. Conclusions: ESX is excellent AED for CAE. But doctors in Korea treat CAE patients only with VPA and LTG. In absence of ESX, polytherapy of VPA plus LTG is better than monotherapy of VPA and LTG for CAE.