A 42-year-old man with a history of acute ischemic stroke 6 months ago presents to the emergency department following a seizure witnessed by his wife. She reports he suddenly lost consciousness and then displayed bilateral symmetric tonic-clonic movements of all extremities lasting approximately 4 minutes. After the movements stopped, he was unresponsive and confused for 10 minutes before gradually regaining alertness. Vital signs on arrival: BP 158/92 mmHg, HR 115/min, RR 8/min, temperature 37.2°C, SpO2 92% on room air. Physical examination reveals no fever, no neck stiffness, and no acute focal neurologic deficits. Prior brain MRI showed a cortical infarction in the left motor cortex. Laboratory studies show normal serum glucose, normal electrolytes, and negative urine drug screen. Which of the following best describes this seizure event?
- A)Primary generalized tonic-clonic seizure with unknown etiology
- B)Status epilepticus requiring immediate intubation and ICU admission
- C)Provoked seizure secondary to acute metabolic derangement
- D)Secondary generalized seizure arising from a focal cortical lesionGABARITO
- E)Absence seizure with secondary generalized features
Explicação
This patient had a secondary generalized seizure with focal onset (also called focal seizure secondarily generalized). The key features are: (1) structural brain lesion (cortical infarction in motor cortex) providing a known seizure focus, (2) initial loss of ... Ver explicação completa e trilha adaptativa →