15th August 2024

You review a 19-year-old man in the first fit clinic. He was referred from the Emergency Department

You review a 19-year-old man in the first fit clinic. He was referred from the Emergency Department after presenting with a generalised tonic-clonic seizure, which had been filmed by his flatmate. He had been out for his birthday the night before and had not slept well. He reported drinking moderate amounts but taking no drugs.

No reversible cause could be found at the time, and the CT head was normal, so he was discharged with the referral.

On further questioning, he reports that he has had episodes of clumsiness in the mornings for the last few months, where he feels like his hands become jerky, and he drops things. These resolve spontaneously, and he does not find them troubling.

Which is the single most appropriate therapy to initiate?

Select the SINGLE most appropriate option from the list below. Select ONE option only.