This week’s free board review question…
A 23-year-old woman presents to you after having experienced a seizure 2 hours ago, her second such seizure in 1 year. Her first seizure was followed by a comprehensive evaluation and no underlying etiology could be identified. As is standard practice after a single seizure with no known cause, she was not started on an antiseizure medication.
This second seizure was witnessed by her boyfriend and was described as loss of consciousness, twitching of all 4 extremities, and loss of urine. The episode was estimated to have lasted for 2 minutes, and the patient was slightly confused for about 1 hour after the episode. She had bitten her tongue.
Physical examination reveals a healthy appearing young woman who is fully oriented and alert. Her vital signs are normal and the entire physical examination is normal.
What is the first consideration when deciding which antiseizure medication to start the patient on?
age of the patient
sex of the patient
type of seizure
etiology of the seizure
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