Ethosuximide Induced Raynaud's Phenomenon in a Child with Childhood Absence Epilepsy
Akshaya Rathin Sivaji1, Jennifer Fittro2, Adina Chirla2, Alexander Namrow2, Jun Park2
1Epilepsy Center, University Hospitals, Cleveland Medical Center, 2Pediatric Epilepsy Center, UH Rainbow Babies & Children's Hospital, Cleveland Medical Center
Background:
Ethosuximide has been widely accepted and used as first line management for childhood absence
epilepsy (CAE) in clinical practice. Ethosuximide has been reported to cause rare idiosyncratic
reactions such as lupus-like syndrome. We report a child with CAE, who developed Raynaud's
phenomenon on day 3 of ethosuximide initiation.
Results:
Case Report:
A 6-year-old boy presented with concerns of multiple staring spells and was diagnosed with CAE following EEG evaluation. He was started on ethosuximide at a dose of 25 mg/kg/day divided BID. On the third day, he reported that his legs were cold, swollen and painful. Upon inspection mother reported clearly demarcated, white skin patches on bilateral feet and toes, confirmed on mom’s uploaded pictures, indicative of Raynaud's phenomenon. Ethosuximide was discontinued, and the symptoms resolved within two days with no intervention. He was exposed to no new medications recently, and ethosuximide remained his only medication. There was no familial history of autoimmune conditions.
Conclusions:
Raynaud’s phenomenon is a possible side effect of ethosuximide and may present within first 5
days of initiation. Resolution of RP was seen within two days of medication cessation. Currently,
RP is not included in the drug insert of ethosuximide.
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