A 19-year-old woman experiences her first generalized tonic-clonic seizure. She has no prior medical history, takes no medications, and toxicology screen is negative. MRI brain is normal. After discussing seizure precautions, which of the following is the MOST appropriate next step in management regarding antiepileptic drug therapy?
✓ Correct Answer: Option C
For a first unprovoked seizure with a normal neurological exam, normal neuroimaging, and no high-risk features (e.g., epileptiform EEG, nocturnal seizure), observation is often recommended. The risk of recurrence is approximately 21-45%, and immediate drug therapy is typically reserved for a second seizure.