A 27-year-old man has a first unprovoked generalised tonic-clonic seizure. He returns to baseline after several hours. CT head and basic blood work in...

Question

A 27-year-old man has a first unprovoked generalised tonic-clonic seizure. He returns to baseline after several hours. CT head and basic blood work in the emergency department are normal. What is the most appropriate next diagnostic step?

Accepted Answer

Order an EEG and brain MRI to further evaluate for a structural or epileptogenic cause.

Answer

No further investigation is required; reassure and discharge.

Answer

Start long-term antiepileptic medication without further testing.

Answer

Schedule carotid Doppler ultrasound as first-line imaging.

Answer

Perform lumbar puncture routinely in all first seizures.

ca-mccqe1 MCQ (SBA): First unprovoked seizure

A 27-year-old man has a first unprovoked generalised tonic-clonic seizure. He returns to baseline after several hours. CT head and basic blood work in the emergency department are normal. What is the most appropriate next diagnostic step?