Seizure Disorders USMLE Step 1 Practice Question
A 7-year-old boy is brought to the emergency department after his first seizure. His parents report he was playing video games when he suddenly stopped responding, his body stiffened, and then his arms and legs began jerking rhythmically for approximately 90 seconds. After the jerking stopped, he was confused and drowsy for about 5 minutes before gradually returning to baseline. Vital signs during the post-ictal period show heart rate 118/min, respiratory rate 22/min, and temperature 37.2°C. There was no fever preceding the event, and he has no history of head trauma, infections, or metabolic disturbances. Physical examination reveals no focal neurologic deficits. His father recalls having similar generalized seizures as a child that resolved by age 12 without requiring long-term antiepileptic therapy. EEG performed the following day shows generalized 3-Hz spike-wave discharges during photic stimulation. Brain MRI is unremarkable. Which of the following is the most likely diagnosis?
Answer choices
- AFocal seizure arising from the rolandic region with secondary generalization
- BChildhood absence epilepsy
- CJuvenile myoclonic epilepsy
- DPost-traumatic epilepsy with generalized tonic-clonic seizures
- EChildhood-onset generalized tonic-clonic epilepsy with primary generalized seizuresCorrect answer
- FTemporal lobe epilepsy with focal seizures secondarily generalizing
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.