A 9 y/o boy is sent for neurologic evaluation because of episodes of "confusion". Over the past year, the child has experienced episodes during which he develops a blank look on his face and fails to respond or respond with unintelligible answer to questions. However, it appears to take several minutes before the boy recovers from the episodes. Which of the following therapies would be appropriate for this patient?
A) Ethosuximide
B) Carbamazepine
C) Diazepam
D) Carbamazepine plus primidone
E) Felbamate
The right answer is B) Carbamazepine
This is NOT an absence seizure...this is a "Complex Partial Seizures"
"fails to respond or respond with unintelligible answer to questions. However, it appears to take several minutes before the boy recovers from the episodes."
Absence seizures are a type of generalized seizures
On clinical examination, typical absence seizures appear as brief staring spells. Patients have no warning or postictal phase, and if engaged in gross motor activity, such as walking, they may stop and stand motionless or they may continue to walk. Children are not responsive during the seizure and have no memory of what happened during the attack; they are generally unaware that a seizure has occurred.
Feature.........Complex Partial.......................Absence
Onset ...........May have simple partial onset....Abrupt
Duration........Usually >30 s..........................Usually < 30 s
Ending..........Gradual postictal......................Abrupt
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