Carter McNeely is a 68-year-old man whose seizures are well controlled with carbamazepine monotherapy. The seizure from

[answerhappygod]

Carter McNeely is a 68-year-old man whose seizures are wellcontrolled with carbamazepine monotherapy. The seizure from 2.5weeks ago was the first seizure in 20 months. During the seizure,he fell to the floor and sustained a laceration to his occipitalregion that required staples for closure. The description of hisseizures is vague because there have been only six seizuresdocumented since he developed epilepsy 3 years ago. Because MrMcNeely lives alone in an assisted living facility, only half ofthe documented seizures have been witnessed by another individualwho could provide a description. Two seizures were witnessed byother residents who described him as “falling to the ground andstarting to shake.” One seizure occurred in the day room when afacility nurse was in the room, and he documented that Mr McNeelyfell to the ground, developed rhythmic extensions to both his legs,became incontinent of urine, and was sleepy and disoriented for 2hours after the episode. He has only been treated withcarbamazepine. This was started by his family practice physicianafter his second seizure. An EEG was obtained at that time and wasunremarkable. Because the seizures are so infrequent, the dose ofcarbamazepine has never been adjusted.
PMH
Tonic–clonic seizures diagnosed 3 years ago
HTN adequately controlled with lisinopril monotherapy
Dyslipidemia controlled with atorvastatin and low-cholesteroldiet BPH, currently symptom-free on dutasteride
FH
Mother died at age 74 of “natural causes”; had HTN for manyyears. Father died at age 70 of “natural causes”; did not have anyknown medical illnesses. All of his children and grandchildren arealive and well. One son and one daughter have HTN.
SH Retired factory worker; resides in an assisted livingfacility. He is widowed and has six children and ninegrandchildren, whom he sees frequently. He denies past or presenttobacco and illicit drug use. He reports a history of regularalcohol use but now only drinks one beer that his grandson bringsto him every Saturday evening.
Meds
Aspirin 81 mg PO once daily
Atorvastatin 40 mg PO once daily
Carbamazepine XR 200 mg PO twice daily
Dutasteride 0.5 mg PO once daily Lisinopril 20 mg PO oncedaily
Multivitamin with minerals one tablet PO once daily
What additional information is needed to fully assess thepatient’s problems related to epilepsy or his drug therapy?