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High impact grand mal
  1. Ami Schattner
  1. Correspondence to Professor Ami Schattner, The Faculty of Medicine, Hebrew University and Hadassah Medical School, 91120 Jerusalem, Israel; amischatt{at}gmail.com

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A 30-year-old woman developed recurrent grand mal seizures 3 months after a motor vehicle accident with mild head and neck injury. She had a history of chronic hepatitis C following a blood transfusion in childhood but liver function tests were normal and there was no history of alcohol or drug abuse. Neurological examination and MRI were normal. Electroencephalogram demonstrated generalised epileptiform activity. Valproate/lamotrigine were started.

Five uneventful months later, she …

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