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CRION – Seronegative Relapsing Optic Neuritis — SCE Neurology MCQ

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HardNeuro-ophthalmologyCRION – Seronegative Relapsing Optic NeuritisSCE Neurology

A patient with a first generalised tonic–clonic seizure has a lateral tongue bite, postictal confusion and no provoking metabolic disturbance. MRI and EEG are pending. What is the most appropriate immediate counselling?

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Correct answer: C — Discuss recurrence risk, first aid, bathing and height precautions, work risks and mandatory driving cessation, clinically

The best answer is “Discuss recurrence risk, first aid, bathing and height precautions, work risks and mandatory driving cessation, clinically”. Safety and driving advice cannot wait for test results, whereas long-term medicine choice depends on recurrence risk, syndrome and individual circumstances. “Reassure that one seizure has no safety or driving implications” can be reasonable in another presentation, but it does not account for the defining feature here. “Start valproate before classifying seizure type or discussing reproductive risk” can be reasonable in another presentation, but it does not account for the defining feature here. “Prohibit all exercise permanently” can be reasonable in another presentation, but it does not account for the defining feature here. “Advise family to restrain the person and place an object in the mouth during another seizure” can be reasonable in another presentation, but it does not account for the defining feature here.

Reference: NICE NG217 epilepsy recommendations: https://www.nice.org.uk/guidance/ng217/chapter/Recommendations