What is the correct answer?


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?

A. Levetiracetam

B. Phenytoin

C. Topiramate

D. Carbamazepine

Correct Answer :

C. Topiramate

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.

Related Questions

Topic: Subarachnoid HemorrhageSubject: MedicineA 25-year-old male presents… Topic: Horner's SyndromeSubject: MedicineA 66-year-old diabetic man presents… Topic: Mini Mental Status Exam (or MMSE)Subject: MedicineWhile performing… Topic: Mini Mental Status Exam (or MMSE)Subject: MedicineIn healthy adults,… Topic: Alzheimer's DiseaseSubject: MedicineWhich one of the following… Topic: Temporal ArteritisSubject: MedicineA 75-year-old female presents… Topic: Huntington ChoreaSubject: MedicineA patient previously diagnosed… Topic: Korsakoff's PsychosisSubject: MedicineIn a patient with recent… Topic: SeizureSubject: MedicineA 36-year-old male with a history of a… Topic: Huntington diseaseSubject: MedicineA 42-year-old white male is… Topic: Essential TremorSubject: MedicineA 75 year old white male complains… Topic: Alzheimer's DiseaseSubject: MedicineA 62 year old woman has demonstrated… Topic: Horner's SyndromeSubject: MedicineA 70-year-old man presented with… Topic: Adverse Drug EffectSubject: MedicineWhich one of the following… Topic: Diagnostic InvestigationsSubject: MedicineA 50-year-old male is… Topic: Alzheimer's DiseaseSubject: MedicineWhich one of the following… Topic: SeizureSubject: MedicineA 52-year-old male with a history of seizure… Topic: Adverse Drug EffectSubject: MedicineDuring the morning rounds,… Topic: Dementia Subject: MedicineAll of the following dementias can benefit… Topic: Normal Pressure HydrocephalusSubject: MedicineAn 81-year-old female… Topic: Subarachnoid HemorrhageSubject: MedicineA 36-year-old female presents… Topic: DementiaSubject: MedicineAn 85 year old white male is brought to… Topic: DM neuropathySubject: MedicineIn which of the following diseases… Topic: Osmotic DemyelinationSubject: MedicineOsmotic demyelination can… Topic: SeizureSubject: MedicineA 32-year-old female experiences an episode… Topic: Benign Positional VertigoSubject: MedicineWhich one of the following… Topic: Delirium TremensSubject: MedicineA patient with delirium tremens… Topic: Brain DeathSubject: MedicineA 30 year old man has been on life… Topic: Neurologic painSubject: MedicineA 21-year-old man presented to… Topic: Status EpilepticusSubject: MedicineWhich one of the following should…