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23 January, 12:39

A 17-year-old woman presents 2 days following a generalized seizure, her second in 6 months. Both seizures occurred between 3 AM and 6 AM while she was sleeping, the week before her menses. Her medical history is unremarkable. She takes no medications. Her general physical and neurologic examinations are normal. Pregnancy test in the emergency room was negative. An EEG was interpreted as revealing activity consistent with a generalized seizure disorder. Which of the following treatments would be best at this time?

a. carbamazepine

b. lamotrigine

c. phenytoin

d. topiramate

e. valproic acid

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  1. 23 January, 13:09
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    valproic acid, lamotrigine and topiramate.

    Explanation:

    She's only 17, a teenager. Her seizures were in the middle of the night (3 a. m) or almost around awakening time (6 a. m), in the last sleep phases. Her physical condition is ok. So, her generalized seizure disorder could fit actually in a Juvenile Myoclonic Epilepsy, an epileptic syndrome. Any doctor could prescribe firstly Valproic Acid, followed by Lamotrigine and Topiramate as the best Anticonvulsant meds, as his alternate options.
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