Topic: Seizure
Subject: Medicine
A 68-year-old man with a history of urolithiasis, suffered from a seizure attack which involved loss of consciousness with tonic and clonic muscular contractions. His tongue fell back into his throat and he choked.
Which of the following medications is contraindicated in this patient's treatment?

This patient suffers from tonic-clonic seizures (formerly known as grand mal seizures), which is characterized by sudden loss of the consciousness followed by tonic and clonic muscular contractions. Patients with a history of kidney stones or those taking high-dose vitamin C or calcium supplementation should not take Topiramate because of the increased risk of kidney stones. Valproic acid is considered the agent of first choice for the treatment of grandmal (tonic-clonic) seizures. Phenytoin and carbamazepine are reasonable second options among the older group of medications, but the newer medications tend to work equally well if not better and have better side effect profiles, especially long-term side effect. Levetiracetam is indicated for primary generalized tonic-clonic seizures in adults and children aged 6 years or older, as well as for use in juvenile myoclonic epilepsy and for partial seizures.