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Chapter 31. Epilepsy

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BW is a 28-year-old man recently diagnosed with partial seizures. He works as a certified public accountant, and has begun treatment with lamotrigine. In which of the following activities is he most likely to experience difficulties due to his seizure diagnosis?

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A. Performing mathematical calculations

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B. Keeping his driver license

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C. Renewing his accountant license

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D. Applying for graduate school

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Which of the following neurotransmitters appears to be depleted in some patients with epilepsy?

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A. GABA

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B. Glutamate

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C. Serotonin

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D. Acetylcholine

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A 19-year-old woman is experiencing repeated episodes of uncontrolled twitches and jerks of her right hand. She is alert throughout these episodes. Her neurological examination and laboratory tests are normal. An EEG reveals left temporal spikes consistent with seizures. What type of seizure is she most likely experiencing?

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A. Complex partial

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B. Myoclonic

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C. Infantile spasms

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D. Simple partial

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A 17-year-old woman was just diagnosed with juvenile myoclonic epilepsy (JME). Which of the following antiepileptic drugs should be started?

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A. Valproate

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B. Levetiracetam

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C. Oxcarbazepine

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D. Pregabalin

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In which of the following groups of patients is increased monitoring of AED serum concentrations advisable?

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A. Nonpregnant women

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B. Men starting gabapentin

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C. Children

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D. Patients with nonepileptic events

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Three months ago, lamotrigine was added to the therapeutic regimen of a 45-year-old man taking carbamazepine for partial seizures. The physician decides to taper and discontinue the carbamazepine. He is currently taking lamotrigine 600 mg daily. Which of the following lamotrigine doses will most likely be required after the carbamazepine is discontinued?

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A. 400 mg twice daily

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B. 300 mg three times a day

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C. 200 mg twice daily

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D. 50 mg twice daily

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