Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
            e.org 
This is followed by a clonic activity that consists of 
uncoordinated beating movements of the limbs and 
head, forcible jaw closing, and head rocking. Urinary 
incontinence is common.  
 
The seizure usually does not last longer than 90 seconds; 
then movement ceases, muscles relax, and a gradual 
return to consciousness occurs, which is accompanied by 
headache, confusion, and mental dulling.  
 
Several hours of rest or sleep may be needed for the 
patient to fully regain cognitive and physical abilities. 
 
 
www.drcube.org 
b. Tonic-clonic seizures  
(grand mal) 
A major fit is so dramatic that it seems to be of longer 
duration that is in fact the case but if it lasts more than 5 
minutes (by the clock) or starts again after apparently 
ceasing, the patient must be regarded as being in status 
epilepticus, which is particularly dangerous (the 
mortality can be up to 20%).  
 
Brain damage may result from cerebral hypoxia, when 
tonic and clonic phases alternate repeatedly without 
consciousness being regained and there can also be 
inhalation of vomit and saliva.  
 
www.drcube.org 
b. Tonic-clonic seizures  
(grand mal) 
This condition is most frequently caused by abrupt 
withdrawal of anticonvulsant medication or an abused 
substance that may be triggered by infection, neoplasm, 
or trauma.  
Status epilepticus constitutes a medical emergency. 
b. Tonic-clonic seizures  
(grand mal) 
www.drcube.org 
Laboratory findings 
 
Other diagnostic procedures that are useful for 
ruling out other causes of seizures include: CT, MRI, 
lumber puncture, serum chemistry profiles, and 
toxicology screening 
The diagnosis of epilepsy generally is based on the 
history 
of 
seizures 
and 
an 
abnormal 
electroencephalogram (EEG).  
www.drcube.org 
Medical management 
 
The medical management of epilepsy is usually based 
on long-term drug therapy. Phenytoin (Dilantin), 
carbamazepine 
(Tegretol), 
and 
valproic 
acid 
(Depakene) are considered first-line treatments.  
 
These drugs act by reducing the frequency of seizures 
by elevating the seizure threshold of motor cortex 
neurons, depressing abnormal cerebral electrical 
discharge, and limiting the spread of excitation from 
abnormal foci. 
www.drcube.org 
Phenytoin and carbamazepine are efficient at blocking 
sodium or calcium channels of motor neurons. 
 
Phenytoin, carbamazepine, and valproic acid can 
cause bone marrow suppression, leukopenia, and 
thrombocytopenia, resulting in an increased incidence 
of microbial infection, delayed healing, and gingival 
and postoperative bleeding.  
 
Valproic acid can decrease platelet aggregation, 
leading to spontaneous hemorrhage and petechiae. 
www.drcube.org 
Adverse effects of phenytoin: gingival hyperplasia, 
increased incidence of infection, delayed healing, 
gingival bleeding (leukopenia), osteoporosis, and 
Stevens-Johnson 
syndrome. 
{Metronidazole 
can 
interfere with phenytoin}. 
Adverse 
effects 
of 
carbamazepine: 
xerostom

            Quiz: