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Rheumatoid arthritis — RCPSC IM MCQ

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HardRheumatologyRheumatoid arthritisRCPSC IM

A 19-year-old has recovered after a first unprovoked generalized seizure. MRI and examination are normal; EEG is pending. How should long-term antiseizure medication be approached?

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Correct answer: D — Use individualized recurrence risk and shared decision making

The best answer is “Use individualized recurrence risk and shared decision making”. Immediate long-term treatment after one unprovoked seizure is not automatic. EEG, MRI, neurologic history and patient priorities inform recurrence risk and the benefit-harm tradeoff; no follow-up underestimates risk, benzodiazepines are unsuitable maintenance treatment and prolonged routine admission is unnecessary.

Reference: International League Against Epilepsy, treatment after a first unprovoked seizure. https://www.ilae.org/news-and-media/clinical-research/antiepileptic-drug-treatment-after-an-unprovoked-first-seizure-a-decision-analysis