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What is the treatment of absence seizures?

Q: My 4 years old son had first attack of epilepsy four months back. After doing EEG, which showed petit mal, so we started sodium valproate 2 ml. But next month he again had an attack then we increased the dose to 3 ml. Then again the next month he had 2 attacks in one day. Now his dose has been increased to 5ml. His recent MRI and EEG were normal. What dose should be given so that there would be no seizure? The neurologist has advised us to start Lamotrizine as an adjuvant therapy but the paediatrician is not allowing. What should I do? Please suggest.

A:If your child has absence seizures (old name petit mal), the EEG should be very typical. The fact that the EEG has normalised is a good sign. An MRI is not required in typical absence seizures. A dose of 5 ml of Valparin twice daily is a good dose and you should wait. Do not increase if he has just one absence. I would suggest you maintain a record of the absences for a month. If they are not controlled, the dose of Valparin could be increased, but I would at that stage use Lamotrigine because it has a positive effect on alertness and mental performance and is a good drug.

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