ABSTRACT
The patient was commenced on valproate but her attacks were not fully controlled on 38 mg/kg per day. She had a further cluster of seizures in December 2000, including unusual attacks with bilateral facial clonic activity with limp limbs; these attacks required rectal diazepam after 5 minutes. Higher doses of valproate will be tried, and if this does not produce full seizure control, lamotrigine will be introduced in combination with valproate.
