AED | Audio Epilepsy Digest Episode 022 Companion

AED Quiz

The Epilepsy Follow-Up: Continue, Adjust, Switch—or Refer?

Three everyday outpatient decisions, with a medication-safety check.

This AED Quiz is for self-assessment and journal-club discussion. It is not accredited CME and does not provide CME credit.
EpisodeThe Epilepsy Follow-Up: Continue, Adjust, Switch—or Refer?
ReviewAI editorial/source review
ListenCanonical audio file

Learning Objectives

  1. Apply medication-specific baseline testing instructions.
  2. Distinguish tolerability from seizure control.
  3. Recognize when adequate medication trials warrant referral.

Questions

1. An adult is preparing to start cenobamate. What does its August 2025 US label specify about baseline liver tests?
Correct answer: A. Xcopri prescribing information sections 2.1 and 5.4 specify ALT, AST and total bilirubin before initiation unless recently available within three months. During treatment, monitor symptoms and test promptly when clinically indicated; the label does not specify a universal monthly schedule.
2. A seizure-free patient reports fatigue and poor daily functioning. What is the best interpretation of the SANAD II evidence for this visit?
Correct answer: C. SANAD II supports considering tolerability and treatment retention alongside seizure outcomes. It studied newly diagnosed focal epilepsy, not switching stable patients or comparing cenobamate.
3. A patient remains without sustained seizure freedom after two adequate, appropriately selected and used, tolerated medication schedules. What should this prompt?
Correct answer: B. The ILAE referral consensus supports timely evaluation once drug resistance is established. Referral assesses options and can improve care even when surgery is not performed.
4. A patient taking cenobamate develops unexplained nausea, dark urine and jaundice. What is the appropriate response?
Correct answer: D. The label calls for prompt ALT, AST and total bilirubin testing for symptoms suggesting hepatic dysfunction. Liver injury without another cause warrants interruption or discontinuation under clinician direction; this is different from routine tolerability adjustment.

Reflection

What would change how you discuss this episode's evidence in journal club, clinic, or surgical conference?

Review Basis

Questions were drafted from the release show note, episode source-review boundary, and available episode planning materials. The page is intentionally framed as self-assessment, not accredited CME.