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Juvenile Myoclonic Epilepsy – Topiramate PPP — SCE Neurology MCQ

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HardEpilepsy & Seizure DisordersJuvenile Myoclonic Epilepsy – Topiramate PPPSCE Neurology

A 16-year-old girl presents with a 6-month history of morning myoclonic jerks of both arms, particularly when sleep-deprived. She has recently had a generalised tonic-clonic seizure after a night out. EEG shows 4–6 Hz generalised polyspike-and-wave discharges with photosensitivity. Her neurologist plans to start an antiseizure medication. According to NICE NG217 (2025), which drug requires a Pregnancy Prevention Programme in females of childbearing potential?

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Correct answer: C — Topiramate

The best answer is “Topiramate”. UK stroke guidance supports urgent vascular imaging and reperfusion selection, short-course dual antiplatelet therapy for eligible minor stroke or high-risk TIA, decompression for life-threatening swelling, and secondary prevention matched to mechanism. The alternatives “Levetiracetam”, “Lamotrigine”, “Zonisamide”, “Clobazam” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: National Clinical Guideline for Stroke: acute care: https://www.strokeguideline.org/chapter/acute-care/