A 24-year-old woman with no prior seizure history presents after a single generalized tonic-clonic seizure following 3 days of poor sleep, intense stress from medical school exams, and binge drinking the night before. Vital signs: BP 118/76, HR 92, RR 16, Temp 37.2°C, SpO2 98%. Serum glucose 94 mg/dL and electrolytes are normal. Head CT shows no acute abnormalities. She denies tongue biting or incontinence. Which of the following is the most appropriate management?

  1. A)Admit for continuous EEG monitoring for 48 hours
  2. B)Start two antiepileptic drugs to prevent recurrence
  3. C)Perform lumbar puncture to rule out infection
  4. D)Observe without antiepileptic drugs and address provoked seizure triggersGABARITO
  5. E)Start antiepileptic drug monotherapy immediately

Explicação

This is a provoked seizure (sleep deprivation, stress, alcohol) in a patient with no prior seizure history and normal imaging. Provoked seizures do not require long-term antiepileptic therapy; seizure risk is low with avoidance of triggers. Patient education r... Ver explicação completa e trilha adaptativa →

Fazer o diagnóstico grátis de USMLE