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Continue ethosuximide
12%
8/66
Stop the ethosuximide and start him on haloperidol
0%
0/66
Stop the ethosuximide and start him on valproic acid
82%
54/66
Stop the ethosuximide and start him on quitiapine
Stop the ethosuximide and do not start anything else
5%
3/66
Select Answer to see Preferred Response
This patient is experiencing absence seizures. If the patient has tried and failed ethosuximide (1st line treatment) he should then be started on the second line treatment, which is valproic acid. Absence seizures often present in childhood and subside before adulthood. These types of seizures are commonly seen running in families. Symptoms include brief noticeable periods of impaired consciousness and blank stares with fluttering of eyelids. They last only 5-10 seconds and occur hundreds of times a day with no postictal stage. Interestingly, they can be triggered by hyperventilation. EEG often shows a classic three-per-second spike and wave discharge that is characteristic of absence seizures. Incorrect Answers: Answers 1,2,4,5: None of these would be considered great options as Valproic acid is the second line treatment for absence seizures.
4.5
(4)
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