Question

A 60-year-old man develops involuntary shaking of his right arm that spreads to the face, after which he collapses with whole body shaking and lack of consciousness. After 1 minute, the shaking stops and he is confused and disoriented.

1. What type of seizure is suggested by the clinical manifestations?
2. Assuming that this is his first seizure, what diagnostic tests should be performed to identify the cause?
3. Assuming he has a history of seizures, what treatments should be instituted?

Answer 1

1.Based on the mentioned clinical manifestations, the described seizure is a tonic-clonic seizure.The is the most common motor seizure which makes the muscles stiffen,lose of consciousness and convulsions.

2.Diagnostic tests to be performed:

• History and neurological examination
• Physical examination and laboratory studies to find out any metabolic disease
• CT scan/MRI scans to identify structural defects
• EEG to record brain's electrical activity

3.Treatment to be given if the patient has history of seizures:

• Anticonvulsant medications
• Carbamazepine.gabapentine,levitiracetam,lamotrigine,valproic acid are the drugs of choice in tonicclonic seizures.