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SPOT LIGHT ON MEDICINE 2024 MCQS BOOK DR FADI QUTISHAT Medicine 12/2023 1) A 27-year-old man presents with history of fits consistent with tonic-clonic seizures. What is the most suitable first line treatment A. Gabapentin B. Lamotrigine C. Sodium Valproate D. Carbamazepine E. Phenytoin Explanation For patients treated for generalized and unclassifiable epilepsy, the first SANAD trial found that valproate and lamotrigine were superior to topiramate in regard to time to treatment failure. For time to 12- month seizure remission, valproate and topiramate were more efficacious compared with lamotrigine. In the SANAD II trial, by intention-to-treat analysis, levetiracetam did not meet noninferiority criteria compared with valproate for time to 12-month seizure remission.
SPOT LIGHT ON MEDICINE 2024 MCQS BOOK DR FADI QUTISHAT
SPOT LIGHT ON MEDICINE 2024 MCQS BOOK DR FADI QUTISHAT Note that although there is evidence to support the use of these medications for these seizure types, the medication may not be indicated for this use by the US Food and Drug Administration. * May worsen or precipitate myoclonic seizures. ¶ Previously referred to as secondary generalized seizures. Δ Some evidence of efficacy for generalized-onset tonic-clonic seizures, but may also worsen certain generalized seizure types. ◊ Potential to worsen certain generalized seizure types.

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