Question

A 22-year-old man presents to a metropolitan ED after a witnessed generalised tonic-clonic seizure lasting 3 minutes. He is now alert with normal neurological examination. CT brain and routine blood tests (including glucose, electrolytes and calcium) are normal. He has no previous seizures and no risk factors for CNS infection. What is the most appropriate management plan?

Accepted Answer

Arrange outpatient EEG and neurology review before deciding on long-term antiepileptic therapy

Answer

Start long-term sodium valproate immediately and arrange neurology follow-up

Answer

Discharge without further follow-up as investigations are normal

Answer

Admit to ICU for continuous EEG monitoring

Answer

Start phenytoin infusion in the emergency department as secondary prophylaxis

Practice question