Medical Emergencies · patient case question
Which is NOT a feature of a generalised tonic–clonic seizure?
Patient case: Autistic patient taking an antiepileptic
Patient: Patient with autism spectrum disorder
Chief complaint: Attends for routine dental care.
Background: Epilepsy, treated with valproic acid. History of generalised tonic–clonic seizures.
Current findings: Cooperative with a structured, predictable approach.
Show answer and explanation
Correct answer: B. Repetitive verbal behaviour
- A. Loss of consciousness is definitional for a generalised seizure.
- B. CORRECT — this is the EXCEPTION. Repetitive verbal or motor behaviour (stereotypy) is a feature of AUTISM, and repetitive automatisms such as lip-smacking characterise FOCAL seizures with impaired awareness. It is not a feature of a generalised tonic–clonic seizure, in which consciousness is lost outright.
- C. Tonic rigidity followed by clonic jerking is the defining motor sequence.
- D. The patient is entirely unresponsive throughout.
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