A 25 year old recently married woman had history of new onset seizure. She has a positive family history of epilepsy. Her examination is normal. BEG showed a generalized spike and waves complexes. Which of the following is the most appropriate next step in management?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Start Lamotrigine
One unprovoked seizure with epileptiform abnormalities on EEG (generalized spike-and-wave) is a high recurrence risk, so it counts as epilepsy and treatment should start now, not after a second seizure (D).
- Generalized epilepsy responds best to valproate, but valproate should be avoided in women of reproductive age because it is teratogenic. This newly married woman should get lamotrigine (or levetiracetam), which is preferred in pregnancy.
- Carbamazepine (B) is mainly for focal seizures.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Valproate suits generalised epilepsy, but pregnancy-related problems mean it should not be used in women of reproductive age unless the benefits outweigh the risks; this woman is newly married.
✓ Epilepsy D.pdf · p. 6 -
B
ليش غلط
Carbamazepine is first-line for focal seizures and only second-line for generalised tonic-clonic seizures, and it is contraindicated in pregnancy (neural tube defects).
✓ Neurology 🧠.pdf · p. 14 -
C
ليش صح
Lamotrigine is preferred in pregnancy because of its low teratogenic potential, which makes it the sensible choice for a woman of child-bearing age with generalised epilepsy.
✓ Basics of Neurology-Ali Rawas.pdf · p. 161 -
D
ليش غلط
Treatment need not wait for a second seizure when one unprovoked seizure carries a high recurrence risk, such as an EEG with epileptiform abnormalities (as here).
✓ Basics of Neurology-Ali Rawas.pdf · p. 162
- المصدر
- Basics of Neurology-Ali Rawas.pdf · p. 162
Epilepsy D.pdf · p. 6
Basics of Neurology-Ali Rawas.pdf · p. 161 - المحاضرة
- Seizures & Epilepsy · Neurology · Module C
- ظهر في
- MED43 ♂ Quiz C · MED43 ♀ Compre