LS is a 31-year-old woman who presents

Posted: January 18th, 2023

Epilepsy: A Case Study Analysis
The case of LS, a 31-year-old woman who experienced a first-time seizure, raises important considerations regarding the diagnosis and management of epilepsy. This paper analyzes the presented information, identifies potential risk factors, recommends diagnostic studies, and proposes an appropriate course of action for antiseizure therapy.
Risk Factor Analysis
An important risk factor that might have contributed to LS’s epilepsy is her history of a febrile convulsion in childhood. Febrile seizures, particularly those occurring after the age of one, are associated with an increased risk of developing epilepsy later in life (Ryu et al., 2019). Furthermore, the fact that LS’s febrile seizure occurred at the age of 10 is noteworthy, as the risk of subsequent epilepsy increases with older age at the time of the febrile seizure (Seinfeld et al., 2021).
Initial Diagnostic Workup
The initial workup, including normal electrolytes, normal blood glucose levels, and negative urine toxicology screening, provides valuable information but does not definitively identify the underlying cause of LS’s seizure. To further understand the risk of recurrent unprovoked seizures, the following diagnostic studies should be obtained:

Magnetic Resonance Imaging (MRI): An MRI of the brain can help identify structural abnormalities, such as tumors, vascular malformations, or lesions, which may be contributing to the seizure activity (Verma & Radtke, 2022).
Electroencephalogram (EEG): Although an EEG was obtained and showed epileptiform discharges over the right temporal head region, it is important to consider that a single routine EEG may not capture all seizure activity. Repeated or prolonged EEG monitoring, including ambulatory or video-EEG, may be necessary to better characterize the seizure type and localize the epileptogenic zone (Aminoff, 2023).

Antiseizure Therapy
Based on the EEG findings of epileptiform discharges over the right temporal head region, the best next course of action in terms of antiseizure therapy is to initiate treatment with an appropriate antiepileptic drug (AED). The choice of AED should consider factors such as the seizure type, potential side effects, drug interactions, and patient preferences (Shorvon, 2019).
For focal seizures with temporal lobe involvement, as suggested by the EEG findings, potential AED options include:

Levetiracetam: A broad-spectrum AED that is generally well-tolerated and effective for focal seizures (Shorvon, 2019).
Lamotrigine: An AED that is particularly effective for focal seizures with temporal lobe involvement and may have additional mood-stabilizing effects, which could be beneficial given LS’s fluoxetine treatment (Aminoff, 2023).
Carbamazepine or Oxcarbazepine: Sodium channel blockers that are effective for focal seizures, particularly those originating from the temporal lobe (Shorvon, 2019).

Initiating appropriate antiseizure therapy promptly is crucial to prevent further seizures and potential consequences, such as injury or cognitive impairment.
Conclusion
In summary, LS’s case illustrates the importance of a thorough diagnostic evaluation and prompt initiation of appropriate antiseizure therapy in individuals presenting with first-time seizures. The risk factor of a childhood febrile seizure, along with the EEG findings of epileptiform discharges over the right temporal head region, provide valuable insights into the potential etiology and guide the treatment approach. Careful consideration of patient-specific factors and close monitoring are essential for optimal management of epilepsy.
References
Aminoff, M. J. (2023). Aminoff’s Neurology and General Medicine (6th ed.). Academic Press.
Ryu, J. H., Kim, D. W., Hong, K. S., & Kwon, S. H. (2019). Risk of epilepsy after febrile seizures in children: A nationwide cohort study. JAMA Pediatrics, 173(9), 863-871. https://doi.org/10.1001/jamapediatrics.2019.2043
Seinfeld, S., Pellock, J. M., Heida, J. G., & Hampson, N. B. (2021). Febrile seizures and the risk of subsequent epilepsy. Current Opinion in Neurology, 34(2), 192-198. https://doi.org/10.1097/WCO.0000000000000906
Shorvon, S. D. (2019). The treatment of epilepsy (4th ed.). Wiley Blackwell.
Verma, A., & Radtke, R. A. (2022). EEG in Clinical Practice (3rd ed.). Wolters Kluwer.
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WEEK 3- PHARM Epilepsy

LS is a 31-year-old woman who presents after a first-time seizure. The patient recalls experiencing an unusual rising sensation in the abdomen accompanied by an unpleasant, brief, metallic taste before losing awareness. write my research paper owl essayservice uk writings.standers observed her to develop leftward head turning followed by stiffening and rhythmic jerking of her limbs. She appeared disoriented for 15 minutes following the event but steadily recovered to baseline functioning.

Past Medical History

• Febrile convulsion in childhood following pneumonia at the age of 10

• No birth-related or developmental complications Medications

• Fluoxetine, 40 mg once daily Family History

• Uncle with alcohol-associated withdrawal seizures

Labs

• Electrolytes: Normal

• Blood glucose level: Normal

• Urine toxicology screening: Negative

Discussion Questions

1. What is an important risk factor that might have contributed to LS’s epilepsy?

2. Initial workup reveals normal electrolytes, normal blood glucose level, and negative urine toxicology screening. Which diagnostic studies should be obtained to further understand the risk of recurrent unprovoked seizures?

3. An EEG is obtained and shows epileptiform discharges over the right temporal head region. What is the best next course of action in terms of antiseizure therapy?
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An important risk factor that might have contributed to LS’s epilepsy is her history of a febrile convulsion in childhood following pneumonia at the age of 10. Febrile seizures are the most common type of seizures in childhood, and while most children who experience them do not develop epilepsy, there is an increased risk of developing epilepsy in those who have had a febrile seizure.
Initial workup reveals normal electrolytes, normal blood glucose level, and negative urine toxicology screening. Additional diagnostic studies that should be obtained to further understand the risk of recurrent unprovoked seizures include an MRI of the brain to evaluate for structural abnormalities or lesions, and an EEG to evaluate for abnormal electrical activity in the brain. An Ambulatory EEG or a Video-EEG may be also obtained to capture the seizures if these are rare.
An EEG obtained shows epileptiform discharges over the right temporal head region, which suggests that LS has temporal lobe epilepsy. The best next course of action in terms of antiseizure therapy would be to start her on an appropriate antiepileptic medication, such as carbamazepine or lamotrigine. The choice of the specific medication will depend on the type of seizures and the patient’s medical history. The medication should be titrated to the minimum effective dose and the patient should be monitored for side effects and efficacy. In addition, the patient should be referred to an Epileptologist for further evaluation, as surgery may be considered in some cases of temporal lobe epilepsy.