ABSTRACT
The patient was initially administered phenytoin but without success. Valproate up to 30 mg/kg per day replaced the phenytoin. Because of continued seizures, a daily dose of 50 mg phenobarbital was combined with the valproate and the seizures disappeared. After 3 years, phenobarbital was tapered off, and as a result of a complete seizure-free period of a further 4 years, valproate was slowly decreased to 25 mg/kg per day. However, a relapse occurred 6 months later. The dosage of valproate was increased to 40 mg/kg per day and later combined individually or in combination with phenobarbital, primidone, carbamazepine, phenytoin and lamotrigine, but without success. More than 1 year later, as a last resort, ethosuximide 750 mg/day in two divided doses was combined with valproate. Since the first dose of ethosuximide over 5 years ago, no seizures have occurred.
