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EEG while taking ethosuximide (Zarontin)

Mon, 09/24/2018 - 00:23
My son was diagnosed with juvenile absence epilepsy nearly 18 months ago at age 12. He was started on Zarontin 250mg once per day, then bumped up to twice per day. He stopped having absence seizures at that dose, even though it was, technically a slightly sub-therapeutic dosage for his weight. He has since had a huge growth spurt and is now about 20 lbs heavier than he was when he began that dose, but he still hasn't had any more absence seizures. His bloodwork has shown low, but not insignificant, levels of Zarontin. However, due to scheduling, his bloodwork has generally been performed only a few hours after his morning dose. Obviously, the levels would be lower if he were approaching his evening dose. Given that he's at such a low dose of medication for his weight, his neurologist suggested a repeat EEG. He said that if the EEG appears normal, we could try weaning him off his medication. I asked if the Zarontin, even at a low dose, might effect the EEG such that it showed up as normal, even if he still has JAE. The neurologist said that there would still be epileptic activity even with successful medication treatment, so that a normal EEG would be a good sign. Doing my own research, I found a couple of articles that seemed to indicate otherwise... that Zarontin would likely negate the spike and wave patterns of absence epilepsy. If this is the case, I'm afraid that his EEG might not be an indicator that he might have outgrown his epilepsy. My understanding is that JAE is rarely outgrown (unlike it's similar condition, CAE). Does anyone know which is true? Whether Zarontin would mask epileptic activity on an EEG, or whether the EEG would still show the spike and wave patterns of JAE even with medication?

Comments

Often for accurate testing

Submitted by Amy Jo on Wed, 2018-09-26 - 13:00
Often for accurate testing one needs a blood draw just before the next dosing - it's called a trough draw. Check with your doctor before doing another draw. And, yeah, if the diagnosis is accurate, not likely to outgrow. Based on what the doc says, which is very odd about drug effect on EEG, have you considered switching docs? Our child has atypical absence and we checked if the meds were working by whether the EEG showed activity. I think it's fairly normal to check how well drugs are working for absence with an EEG.

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