ABPN ABPN Epilepsy and Seizure Disorders 2

Question 1

Which antiepileptic drug is considered the preferred first-line agent for juvenile myoclonic epilepsy?

Accepted Answer

Valproate

Answer

Valproate is the most effective broad-spectrum agent for JME, controlling myoclonic jerks, absence, and generalized tonic-clonic seizures.

Question 2

Which antiepileptic drug should be AVOIDED in juvenile myoclonic epilepsy because it may paradoxically worsen myoclonic seizures?

Accepted Answer

Carbamazepine

Answer

Carbamazepine is a sodium channel blocker that may worsen myoclonic and absence seizures and is contraindicated in generalized epilepsy syndromes including JME.

Question 3

A woman with epilepsy is planning a pregnancy. Which antiepileptic drug carries the highest risk of major congenital malformations and cognitive teratogenicity?

Accepted Answer

Valproate

Answer

Valproate has the highest teratogenic risk among AEDs, associated with neural tube defects, craniofacial abnormalities, and significant neurocognitive impairment in exposed offspring.

Question 4

What is the primary mechanism of action of phenytoin?

Accepted Answer

Blocks voltage-gated sodium channels

Answer

Phenytoin stabilizes neuronal membranes by blocking voltage-gated sodium channels in their inactive state, reducing repetitive high-frequency firing.

Question 5

Which antiepileptic drug is most strongly associated with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)?

Accepted Answer

Lamotrigine

Answer

Lamotrigine carries a significant risk of serious skin reactions including SJS/TEN, especially when titrated rapidly or combined with valproate; slow titration substantially reduces this risk.

American Board of Psychiatry and Neurology Practice Test

American Board of Psychiatry and Neurology Practice Test

ABPN ABPN Epilepsy and Seizure Disorders 2