Abstracts

Rationale: Absence epilepsy is one of the most common pediatric epilepsy syndrome, is usually treated with ethosuximide (ESM), valproic acid (VPA) or lamotrigine (LTG). The most superior initial empirical treatment is controversial considering efficacy and adverse effect. This study was purposed to compare the initial therapy outcomes in drugs including the combination of VPA and LTG. Methods: Total 95 patients with typical absence seizure were enrolled and reviewed retrospectively at Korea University Medical Center between January 2005 and March 2014. Clinical characteristics such as age of seizure onset, initial drug and interval to seizure free, duration of seizure free, drug retention rates and breakthrough seizure etc., previous febrile history and EEG (electroencephalogram) findings were studied through medical records. Results: Mean age of seizure onset and follow-up duration was 8.2±5.9 and 4.8±5.9 years. The children who were initially treated with ESM 32 (31.3%), VPA 28 (29.5%), LTG 24 (25.3%), and the combination of VPA and LTG 8 (8.4%). There were no significant differences among the initial therapy with interval to seizure free, duration of seizure free. But, after 48 months of therapy, the drug retention rates for VPA and the combination of VPA and LTG were superior (82.1% and 100%) than ESM and LTG (50% and 41.6%). There is no valuable predict factor of therapeutic response in EEG findings, previous febrile seizure history. Conclusions: This study showed initial the combination of VPA and LTG therapy is similar effective with other first line drugs in the treatment of absence epilepsy. The combination of VPA and LTG therapy can be considered in absence epilepsy for first line therapy.