Approach to convulsive status epilepticus Quiz: Ace Your Exams
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A 41-year-old-woman with epilepsy is brought to the emergency department by ambulance for altered mental status and seizure activity. Her partner reports she has been ill with frequent diarrhea for the past three days without fever or headache. Today, she felt weak, and they called for an ambulance. Seizure activity began in the ambulance 10 minutes before arrival. Medical history is notable for generalized epilepsy and gastroesophageal reflux. Daily medications include levetiracetam and omeprazole. She does not drink alcohol or use other recreational substances. Temperature is 36.7°C (98.1°F), pulse is 100/min, respirations are 10/min, and blood pressure is 130/80. On exam, bilateral eyes are open and deviated upwards. She does not respond to verbal commands or painful stimuli. There is no neck stiffness. Cardiopulmonary and abdominal examinations are within normal limits. Bilateral upper extremities are flexed, and bilateral lower extremities are extended, with rhythmic jerking in both the upper and lower extremities. A finger-stick glucose is normal. Administration of intravenous lorazepam stops the movements. Which of the following tests would likely confirm the cause of her seizure activity?
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