A 34-year-old woman presents with recurrent episodes beginning with olfactory hallucinations and déjà vu, followed by lip smacking and 2-3 minutes of altered consciousness. She reports postictal confusion and fatigue lasting 30 minutes after each event. Vital signs: BP 128/82, HR 92, RR 16, temp 37°C, SpO2 98% on room air. Brain MRI reveals left mesial temporal sclerosis. She denies tongue biting or incontinence. She takes no medications. Which diagnosis best explains these findings?

  1. A)Psychogenic nonepileptic seizure
  2. B)Focal impaired awareness seizureGABARITO
  3. C)Absence seizure
  4. D)Focal aware motor seizure
  5. E)Juvenile myoclonic epilepsy

Explicação

Olfactory aura, déjà vu, automatisms, and postictal confusion are classic for a focal impaired awareness seizure arising from the temporal lobe. Temporal lobe circuits involved in memory and emotion often produce these experiential auras. Ver explicação completa e trilha adaptativa →

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