Neurology: childhood absence epilepsy: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Neurology: childhood absence epilepsy

Sample item

An 8-year-old girl has many daily episodes of staring for about 10 seconds with eyelid fluttering, abrupt recovery and no postictal confusion. Hyperventilation reproduces an episode, and EEG shows generalised 3 Hz spike-and-wave discharges. She has no other seizure type. What is the drug of choice?

ACarbamazepineBPhenytoinCVigabatrinDEthosuximide

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Ethosuximide

Childhood absence epilepsy has typical 3 Hz spike-and-wave EEG and is treated with ethosuximide, which blocks T-type calcium channels in thalamic neurons. Valproate is an alternative, particularly if generalised tonic-clonic seizures coexist. Sodium channel blockers can aggravate absence seizures.

Option by option

A. Carbamazepine
Carbamazepine can worsen absence seizures, and is a focal seizure drug.
B. Phenytoin
Phenytoin does not control absence seizures and may aggravate them.
C. Vigabatrin
Vigabatrin can aggravate generalised absence and myoclonic seizures and is used for infantile spasms.
D. Ethosuximide (correct)
Correct. Ethosuximide is first-line for absence seizures when they are the only seizure type.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Ethosuximide. Childhood absence epilepsy has typical 3 Hz spike-and-wave EEG and is treated with ethosuximide, which blocks T-type calcium channels in thalamic neurons.

Why is "Carbamazepine" not the answer?

Carbamazepine can worsen absence seizures, and is a focal seizure drug.

Why is "Phenytoin" not the answer?

Phenytoin does not control absence seizures and may aggravate them.

Why is "Vigabatrin" not the answer?

Vigabatrin can aggravate generalised absence and myoclonic seizures and is used for infantile spasms.

What concept does this question test?

It tests Neurology: childhood absence epilepsy in General Medicine. Valproate is an alternative, particularly if generalised tonic-clonic seizures coexist. Sodium channel blockers can aggravate absence seizures.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neurology: childhood absence epilepsy?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.