A 28-year-old man presents with a first generalised tonic-clonic seizure. CT head and MRI are normal, EEG shows a generalised epileptiform pattern and...

Question

A 28-year-old man presents with a first generalised tonic-clonic seizure. CT head and MRI are normal, EEG shows a generalised epileptiform pattern and metabolic workup is normal. He has no provoking factors. According to Canadian epilepsy guidance, what is the most appropriate management?

Accepted Answer

Start an antiseizure medication such as levetiracetam because he is at increased risk of recurrence.

Answer

Do not start antiseizure medication after a first unprovoked seizure in all patients.

Answer

Start benzodiazepines as long-term prophylaxis.

Answer

Arrange neurosurgical evaluation for resection.

Answer

Recommend driving without restrictions because imaging is normal.

ca-mccqe1 MCQ (SBA): First unprovoked seizure

A 28-year-old man presents with a first generalised tonic-clonic seizure. CT head and MRI are normal, EEG shows a generalised epileptiform pattern and metabolic workup is normal. He has no provoking factors. According to Canadian epilepsy guidance, what is the most appropriate management?