Quiz 07/17/2022 (2)

The combination of lamotrigine and which of the following drugs increases the risk of lamotrigine toxicity?

A 21-year-old woman with a past medical history of depression presents with recurrent episodes of out-of-body sensations lasting 30 seconds. This may be followed by 1-2 minutes of staring and unresponsiveness that she does not remember. She often remains confused for 10 minutes after an event. They occur 1-3 times every 2 weeks. An MRI brain is done and shows no pathology. Which test is the most diagnostically valuable next step in her workup?

A 40-year-old male with bilateral mesial sclerosis and medically refractory epilepsy presents to the epilepsy monitoring unit for a presurgical evaluation. His current anti-seizure medication regimen includes levetiracetam, lamotrigine, and clobazam. Over three days and weaned medication, the patient had 7 seizures; four from the left temporal lobe, and three from the right temporal lobe. Which of the following is the most appropriate next step in treatment?

Which of the following antiepileptic drugs can induce myoclonic seizures?

Which of the following is not a known side effect of chronic phenytoin use?

You are caring for a 1-year-old girl with severe refractory epilepsy with frequent focal seizures. She had normal developmental until 3 months of age when she had seizure onset as well as a loss of milestones. Continuous EEG revealed multiple seizure types, with multiple foci of onset in each hemisphere. The seizures appear to migrate between hemispheres on EEG, and clinically. Which gene is most often associated with this disorder?

A 67-year-old woman with a past medical history of osteoporosis, hypertension, bipolar disorder, and a remote right MCA stroke is referred to the epilepsy clinic after experiencing her first epileptic seizure. An EEG has shown right temporal epileptiform discharges. Which of the following medications are most appropriate to start as initial therapy?

A 35-year-old male presents to the neurology clinic for the management of seizures. The patient reports having focal to bilateral tonic-clonic seizures (FTBTC) since the age of 15. His seizures are usually preceded by the smell of burning rubber. He will then have left hand automatisms followed by whole-body tonic-clonic activity. Levetiracetam monotherapy was initially effective. However, 1 year ago seizures returned, occurring once every two months. Lacosamide was added 6 months ago but there has been no significant improvement in his seizure frequency. Levels of these two anti-seizure medications (ASMs) are therapeutic and there have been no concerns regarding medication adherence. What is the most appropriate next step in management?

A 68-year-old woman presents to the emergency room with a 3-month history of worsening cognition, ataxia, dysphagia, and periodic episodes of brachial dystonia, and facial grimacing. A continuous EEG was performed but no EEG correlate was seen with the abnormal movements. An autoimmune process is suspected. Which of the following serum autoantibodies is most likely present?

The following is a sample of gray matter stained with Anti-NeuN and viewed under a low-power microscope lens. The pathology marked by the blue arrow is most consistent with which of the following causes of epilepsy?

A 28-year-old woman of Chinese descent was recently diagnosed with focal/symptomatic epilepsy. Which of the following medications should best be avoided in the management of her epilepsy?

A 32-year-old male with a longstanding history of epilepsy secondary to mesial temporal sclerosis returns to your clinic. Despite being on appropriate doses of levetiracetam and valproic acid he continues to have 20 partial seizures and 4 generalized tonic-clonic seizures per month. Which of the following is the next best step in his care?

An 8-year-old boy with no significant past medical history is brought to the clinic due to difficulties in school. His mother states that over the past year, she has received multiple phone calls from his teacher about his lack of concentration in class. On multiple occasions when asked a question, the patient would blankly stare at the wall and ignore the teacher, but then would return to his normal, talkative self immediately after each episode. An EEG is ordered, which shows 3 Hz generalized spike and wave discharges. The patient would most likely benefit from a medication targeting what?

What seizure type is most commonly seen with the pathology shown in the image below?