ABSTRACT
The patient is a 43-year-old heavy smoker with a history of idiopathic generalized epilepsy with absences since childhood and generalized tonic-clonic seizures, often on awakening.
She stopped taking primidone on the recommendation of her neurologist in July 1998 after being completely seizure free for several years. In October of the same year she was hospitalized for an ischemic middle cerebral artery stroke with transient left sided hemiplegia and received low dose heparin while she was bedridden. At 7:30 in the morning of October 10 she had a generalized tonic-clonic seizure that lasted 1 to 2 minutes according to the nurse’s report. Afterwards the patient complained about moderate pain in both upper legs and difficulty moving her legs in bed. She received an intravenous infusion of 4 mg clonazepam over several hours and oral carbamazepine treatment was started. At 14:00 she had her second tonic-clonic seizure.
