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Differential Diagnosis for First Seizure at 15 Years Old

Single Most Likely Diagnosis

  • Benign Rolandic Epilepsy (BRE): This is a common cause of seizures in adolescents, characterized by focal seizures that often occur at night. It has a good prognosis and is typically outgrown by adulthood.

Other Likely Diagnoses

  • Idiopathic Generalized Epilepsy (IGE): This includes several syndromes like juvenile myoclonic epilepsy, which often presents in adolescence with generalized seizures, myoclonic jerks, or absence seizures.
  • Focal Epilepsy: Not otherwise specified, this can be due to various underlying causes such as hippocampal sclerosis, cortical dysplasia, or other structural abnormalities in the brain.
  • Acute Symptomatic Seizures: These are seizures that occur in close temporal relationship to an acute systemic or CNS insult, such as infection, trauma, or intoxication.

Do Not Miss Diagnoses

  • Central Nervous System (CNS) Infections: Such as meningitis or encephalitis, which can present with seizures and have a high morbidity and mortality if not promptly treated.
  • Cerebral Venous Sinus Thrombosis: A rare cause of seizures, especially if associated with other symptoms like headache or focal neurological deficits.
  • Brain Tumors: Although rare, they can present with seizures, especially if located in areas prone to epileptogenesis.
  • Autoimmune Encephalitis: Conditions like NMDA receptor encephalitis can present with seizures among other psychiatric and neurological symptoms.

Rare Diagnoses

  • Mitochondrial Diseases: Such as MELAS syndrome, which can present with seizures, among other systemic and neurological symptoms.
  • Tuberous Sclerosis Complex (TSC): A genetic disorder that can cause seizures due to the development of cortical tubers.
  • Rasmussen's Encephalitis: A rare inflammatory neurological disease, often presenting with seizures that are difficult to control, and progressive hemiparesis.
  • Genetic Epilepsy Syndromes: Such as Dravet syndrome or Lennox-Gastaut syndrome, which are rare but important to consider due to their distinct management and prognosis.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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