A 62-year-old woman with a 10-year history of hypertension presents to the emergency department following a seizure episode. She reports that while sitting at dinner, she experienced involuntary jerking that began in her right thumb and progressively spread up her right arm over approximately 30 seconds. Throughout the episode, she remained fully alert and aware of her surroundings. She did not lose consciousness and was able to recall the entire event. Her husband notes her speech remained clear during the event. Vital signs are: BP 158/92 mmHg, HR 102/min, RR 18/min, temperature 37.2°C, SpO2 98%. Serum glucose is 98 mg/dL. Brain MRI reveals a 2.5-cm mass in the left central sulcus with surrounding vasogenic edema, suspicious for glioma. Which of the following seizure types BEST characterizes this presentation?

  1. A)Absence seizure with focal motor features
  2. B)Generalized tonic-clonic seizure with impaired awareness
  3. C)Focal seizure with impaired awareness and secondary generalization
  4. D)Focal seizure without impaired awareness and cortical spread (Jacksonian march)GABARITO
  5. E)Myoclonic seizure with preserved consciousness

Explicação

This patient exhibited a classic Jacksonian march—a focal seizure WITHOUT impaired awareness originating in the left motor cortex (central sulcus) with sequential cortical spread causing progressive proximal advancement of jerking activity in the contralateral... Ver explicação completa e trilha adaptativa →

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