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TN – HLA-B*15:02 Before CBZ in Diverse Population — SCE Neurology MCQ

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HardHeadache & Facial PainTN – HLA-B*15:02 Before CBZ in Diverse PopulationSCE Neurology

A 36-year-old with focal epilepsy has been seizure-free for 3 years on levetiracetam and wants to stop treatment. Individual recurrence risk and driving implications have been discussed, and withdrawal is agreed. Which plan best follows NICE?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Reduce levetiracetam gradually over at least 3 months using an agreed individual plan

Explanation lettering: E = shown as A · C = shown as B · A = shown as C · B = shown as E

B is correct. After 2 seizure-free years, NICE calls for an individualised recurrence-risk assessment and shared plan; most antiseizure medicines are then reduced over at least 3 months. A and E are too rapid. C unnecessarily introduces a barbiturate, whose withdrawal generally needs longer. D replaces individualised assessment with an absolute prohibition.

Reference: NICE NG217: antiseizure medication withdrawal: https://www.nice.org.uk/guidance/ng217/chapter/principles-of-treatment-safety-monitoring-and-withdrawal