Table 4.
Choice of ASMs according to the epilepsy syndrome
| Epilepsy syndrome | First-line ASM | Second-line ASM | Resistant IGEs |
|---|---|---|---|
| Childhood absence epilepsy | Ethosuxomide* | Valproate | Ethosuxiomide + valproate; valproate + lamotrigine |
| Lamotrigine | |||
| JAE, JME, Epilepsy with GTCS alone | Valproate | Lamotrigine | Valproate + lamotrigine |
| Levetiracetam | |||
| Topiramate | |||
| Zonisamide | |||
| Clobazam, Perampanel | |||
| IGE in women of child-bearing age | Lamotrigine, Levetiracetam | Topiramate, Zonisamide | Low-dose valproate + lamotrigine |
ASM: Antiseizure medicine; IGE: idiopathic generalized epilepsy; GTCS: generalized tonic-clonic seizure; JAE: juvenile absence epilepsy; JME: juvenile myoclonic epilepsy. *Of all IGE syndromes, only ethosuximide has class I evidence for use in childhood absence epilepsy