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Convulsive status epilepticus — RCPSC EM MCQ

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HardNeurological emergenciesConvulsive status epilepticusRCPSC EM

A 44-year-old develops thunderclap headache with transient right arm weakness. Neurologic examination is now normal and CT at two hours is negative. What is the correct diagnostic plan?

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

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Correct answer: E — Continue urgent vascular and CSF-based SAH assessment outside the Ottawa-rule pathway

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

A is correct. A new neurologic deficit places the patient outside the Ottawa rule’s validated population and warrants continued vascular/SAH evaluation. B misapplies the rule. C overgeneralizes early-CT evidence. D delays a dangerous diagnosis. E lets symptom resolution override high-risk history.

Reference: Emergency Care BC, Subarachnoid Hemorrhage—Diagnosis: https://emergencycarebc.ca/clinical_resource/clinical-summary/subarachnoid-hemorrhage-diagnosis/