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AED Omission in Hospital – Avoidable Seizure — SCE Neurology MCQ

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EasyEpilepsy & Seizure DisordersAED Omission in Hospital – Avoidable SeizureSCE Neurology

A 65-year-old man with known epilepsy on levetiracetam has been stable for years. He is admitted to hospital with pneumonia. His regular levetiracetam is omitted for 48 hours due to a prescribing error. He has a generalised tonic-clonic seizure. What does this scenario illustrate?

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Correct answer: B — The importance of medication continuity in hospital — abrupt AED withdrawal is a common cause of breakthrough seizures in hospitalised epilepsy patients and is an avoidable medication safety error

Abrupt AED withdrawal in hospitalised patients is one of the most common causes of avoidable seizures in hospital. The NHS Patient Safety Agency issued specific alerts about this. AEDs must be prescribed on the regular medication chart, administered at the correct times, and NOT omitted. If the patient is nil-by-mouth, liquid or IV formulations should be used. This is directly analogous to the PD medication omission problem. A: This is iatrogenic, not disease progression. C: The drug was working until stopped. D: Same epilepsy syndrome. E: The omission caused the seizure.

Reference: NHS Patient Safety Alert; NICE NG217