A 9-year-old boy is brought to the physician for recurrent 3-4 minutes episodes of sudden, brief jerking movements involving both arms. He is nonresponsive during these episodes and does not remember them afterward. The patient has never lost consciousness and has no known medical conditions. Family history includes a seizure disorder in his uncle. One week ago, his brother witnessed an episode where he woke up, stared, and made hand gestures. After the incident, he felt lethargic and confused. Examination shows no abnormalities. Which of the following is the best initial treatment for this patient?

Question

A 9-year-old boy is brought to the physician for recurrent 3-4 minutes episodes of sudden, brief jerking movements involving both arms. He is nonresponsive during these episodes and does not remember them afterward. The patient has never lost consciousness and has no known medical conditions.  Family history includes a seizure disorder in his uncle. One week ago, his brother witnessed an episode where he woke up, stared, and made hand gestures. After the incident, he felt lethargic and confused. Examination shows no abnormalities.  Which of the following is the best initial treatment for this patient?

Quizplus · Accepted Answer

Eductional Objective: Broad-spectrum anticonvulsants (eg, levetiracetam, valproic acid) treat both focal and generalized onset seizures, whereas narrow-spectrum anticonvulsants (eg, carbamazepine, phenytoin) are primarily used only for focal onset seizures.  Because the seizures in juvenile myoclonic epilepsy are usually generalized onset (ie, affect both cerebral hemispheres at onset), treatment is with a broad-spectrum agent such as valproic acid.

A 9-Year-Old Boy Is Brought to the Physician for Recurrent