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Clinical Case 2
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1

A 17 year-old male is brought in to the local emergency department after having a generalized tonic-clonic seizure in the gymnasium during his physical education class. He was still seizing when the EMT’s arrived. He was given 2 mg of IV lorazepam in the field with subsequent cessation of seizure activity. He has no known medical history and no witnessed trauma. Family members are unavailable to provide further history. The patient is afebrile and post-ictal. He has no obvious abnormalities other than being sedated. His oxygen saturation is normal on room air and his blood sugar is 145 by fingerstick. Other tests are pending.

Which of the following statements is correct?
A)Most cases of epilepsy have an identifiable cause in adolescents and adults.
B)CNS imaging (CT or MRI) will define an etiology of an initial seizure in less than 10% of cases.
C)A normal EEG does not rule out the possibility of epilepsy in a patient such as this.
D)Initial laboratory screening should, at a minimum, include a CBC and glucose.





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