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Ethosuximide is succinimide compound that is effective in the treatment of absence (petit mal) seizures (Table 14-1).1,2,3, and 4 It is the product of an intense structure-activity research effort to find a specific agent to suppress absence seizures with a relatively low side effect profile. The antiepileptic effect of ethosuximide is thought to be due to its ability to decrease low-threshold calcium currents (T currents) in thalamic neurons.5 The thalamus has a key role in the production of 3 Hz spike-wave rhythms that are a hallmark of absence seizures. Based on recent studies, ethosuximide is considered to be the best choice for initial monotherapy of absence seizures in children because of a high rate of efficacy combined with a low incidence of adverse effects.6,7, and 8

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TABLE 14-1International Classification of Epileptic Seizures With Recommended Therapies

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