FrontalCortex, Inc. is a non-profit corporation dedicated to neurology education.

Pediatric Epilepsy Syndromes 07

Topic: Pediatric

Created on Thursday, October 4 2007 by jdmiles

Last modified on Thursday, October 4 2007.

A 17 year old girl presents after having a generalized tonic-clonic seizure.  She has noticed that, when she brushes her teeth or combs her hair in the morning, she occasionally experiences a brief, involuntary jerk in her upper extremities.  Past medical history is otherwise unremarkable. There is no family history of seizures. Exam is normal. You obtain an EEG, which reveals occasional generalized bilateral polyspikes and spike wave complexes at 5Hz.

Of the following options, which agent is the best choice as a first-line monotherapy treatment?


 
        A) Carbamazepine
 
        B) Clonazepam
 
        C) No treatment is indicated
 
        D) Tiagabine
 
        E) Valproate
 

 


Back to the question = Go back to the top of the page.
See another question like this one = Reload a different version of this question ().
Click here for a random question = Load a random question from the database.
Clone this question = Use this question as a template to create a totally NEW question.
Rate this question = Enter detailed rating for this question!
Average user rating for this question = 4 = How users like you have rated this question.
This question was created on October 04, 2007 by jdmiles.
This question was last modified on October 04, 2007.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Carbamazepine

This answer is incorrect.


This child has juvenile myoclonic epilepsy.  Carbamazepine is not the preferred first-line agent in the treatment of this syndrome.  Carbamazepine may worsen myoclonus if used as monotherapy.

  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




B) Clonazepam

This answer is incorrect.


This child has juvenile myoclonic epilepsy.  Clonazepam is not the preferred first-line agent in the treatment of this syndrome.

  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




C) No treatment is indicated

This answer is incorrect.


This child has juvenile myoclonic epilepsy. Untreated, she is likely to continue having seizures.  Treatment is indicated, usually for life.   (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




D) Tiagabine

This answer is incorrect.


This child has juvenile myoclonic epilepsy.  Tiagabine is not the preferred first-line agent in the treatment of this syndrome.

  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




E) Valproate

This answer is correct.


This child has juvenile myoclonic epilepsy. Valproate is considered the initial treatment of choice. Lamotrigine and topiramate, while not approved by the FDA for this use, are also commonly used as initial monotherapy.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4
Please log in if you want to rate questions.

 

 

 

 

References:

1. Levin, K.H., and Luders, H.O. (Eds.) (2000). Comprehensive Clinical Neurophysiology. W.B. Saunders Company, Philadelphia.
2. Trescher, W.H., and Lesser, R.P. (2004). The epilepsies. In Bradley, W.G., Daroff, R.B., Fenichel, G.M., and Jankovic, J. (Eds.). Neurology in Clinical Practice, Fourth Edition. Butterworth Heinemann, Philadelphia, pp. 1953-1992.
3. Wheless, J.W., Clarke, D.F., and Carpenter, D. (2005). "Treatment of pediatric epilepsy: expert opinion, 2005." J Child Neurol, 20 Suppl 1 S1-56; quiz S59-60. (PMID:16615562)
4. Murphy, ., and Delanty, . (2000). "Primary Generalized Epilepsies." Curr Treat Options Neurol, 2(6) 527-542. (PMID:11096777)
5. Gelisse, P., Genton, P., Kuate, C., Pesenti, A., Baldy-Moulinier, M., and Crespel, A. (2004). "Worsening of seizures by oxcarbazepine in juvenile idiopathic generalized epilepsies." Epilepsia, 45(10) 1282-6. (PMID:15461683)
6. Prasad, A., Kuzniecky, R.I., Knowlton, R.C., Welty, T.E., Martin, R.C., Mendez, M., and Faught, R.E. (2003). "Evolving antiepileptic drug treatment in juvenile myoclonic epilepsy." Arch Neurol, 60(8) 1100-5. (PMID:12925366)
Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4
Please log in if you want to rate questions.

 

FrontalCortex.com -- Neurology Review Questions -- Neurology Boards -- Board Review -- Residency Inservice Training Exam -- RITE Exam Review
pediatric
Pediatric Epilepsy Syndromes 07
Question ID: 100407125
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 10/04/2007
Modified: 10/04/2007
Estimated Permutations: 30240

User Comments About This Question:

0 user entries
Please log in if you'd like to add a comment.