Medico

The

n e w e ng l a n d j o u r na l

of

m e dic i n e

original article

Ethosuximide, Valproic Acid, and
Lamotrigine in Childhood Absence Epilepsy
Tracy A. Glauser, M.D., Avital Cnaan,Ph.D., Shlomo Shinnar, M.D., Ph.D.,
Deborah G. Hirtz, M.D., Dennis Dlugos, M.D., David Masur, Ph.D.,
Peggy O. Clark, M.S.N., Edmund V. Capparelli, Pharm.D.,
and Peter C. Adamson, M.D., for theChildhood Absence Epilepsy Study Group*

A BS T R AC T
Background
From the Cincinnati Children’s Hospital
(T.A.G., P.O.C.) and the University of Cincinnati College of Medicine (T.A.G.) —
both inCincinnati; Children’s National
Medical Center, Washington, DC (A.C.);
Montefiore Medical Center, Albert Einstein College of Medicine, New York (S.S.,
D.M.); National Institute of NeurologicalDisorders and Stroke, Bethesda, MD
(D.G.H.); Children’s Hospital of Philadelphia, Philadelphia (D.D., P.C.A.); and the
Department of Pediatrics and Skaggs
School of Pharmacy and PharmaceuticalSciences, University of California, San Diego, San Diego (E.V.C.). Address reprint
requests to Dr. Glauser at the Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children’s Hospital, 3333Burnet Ave., MLC 2015, Cincinnati, OH
45229, or at tracy.glauser@cchmc.org.
*Members of the Childhood Absence
Epilepsy Study Group are listed in the
Appendix.
N Engl J Med 2010;362:790-9.Copyright © 2010 Massachusetts Medical Society.

Childhood absence epilepsy, the most common pediatric epilepsy syndrome, is usually treated with ethosuximide, valproic acid, or lamotrigine. The mostefficacious
and tolerable initial empirical treatment has not been defined.
Methods

In a double-blind, randomized, controlled clinical trial, we compared the efficacy,
tolerability, andneuropsychological effects of ethosuximide, valproic acid, and lamotrigine in children with newly diagnosed childhood absence epilepsy. Drug doses
were incrementally increased until the child was free of...