An otherwise healthy 17-year-old girl presents with a 4-month history of episodes of déjà vu or unpleasant olfactory aura, follo
wed by a period of staring, confusion, and unresponsiveness that lasts 30 to 90 seconds. She then develops headache, nausea, and extreme fatigue. More recently, the episodes are associated with depersonalization, a sinking feeling, and periods of “blacking out.” She has mild short-term memory deficits on examination. MRI scan of the brain is normal. What medication is likely to improve her symptoms?
Olfactory aura and headaches are common in migraine with aura. Staring, unresponsiveness, and amnesia are uncommon. so, epileptic medicines like nortriptyline or propranolol won't be effective. And because nonepileptic seizures can be difficult of differentiating we need further scan and a different kind of drug, which in or case will be lamotrigine because it helps both conditions without increasing them. The rest mentioned help one but increase the other one.
Lamotrigine is an antiepileptic, also known as a anticonvulsant. This should help reduce her periods of "blacking out" along with the confusion, staring, and unresponsiveness.
