Treatment

• Because even a 1-second generalized spike&wave discharge sometimes affects cognitive function, it is prudent to try to control the seizure as well as possible with minimal drug toxicity.

• Published expert consensus opinion indicates that if initial monotherapy with erthosuximide,valporate,or lamotrigine is ineffective,other appropriate options are zonisamide or topirmamine.

• The combination of EXM and VPA may be more effective than either drug alone

• CZP has been used in refractory cases,although it is limited because of its side effects of sedation and tachyphylaxis.（The combination of VPA and CZP has been associated with precipitation of absence status,but this is rare.）