Utility of hospitalization following a first unprovoked seizure
Article first published online: 13 FEB 2013
© 2013 John Wiley & Sons A/S
Acta Neurologica Scandinavica
Volume 128, Issue 1, pages 61–64, July 2013
How to Cite
Utility of hospitalization following a first unprovoked seizure. Acta Neurol Scand 2013: 128: 61–64. © 2013 John Wiley & Sons A/S., , , .
- Issue published online: 13 JUN 2013
- Article first published online: 13 FEB 2013
- Manuscript Accepted: 5 DEC 2012
- first seizure;
- seizure recurrence
Hospital admission in otherwise healthy patients following a first unprovoked seizure is controversial. We aimed to evaluate the influence of admission in a neurology department on the identification of risk factors for seizure recurrence in patients with a first unprovoked seizure.
Materials and methods
We retrospectively reviewed the medical records of patients with a first unprovoked seizure, who were admitted to the neurology departments at two medical centers between 2007 and 2009. Risk factors for seizure recurrence included the following: abnormal neurological examination, abnormal brain CT scan, and epileptiform discharges on the EEG.
The study group included 97 patients (52 men) aged 18–85 years (mean 42). Eighty-seven (90%) patients were admitted following a generalized tonic–clonic seizure. Risk factors were identified in the emergency room (ER) in 36 (37%) patients, mainly including abnormalities of the neurological examination and brain CT scan. Nineteen (20%) patients had a risk factor which was not apparent during ER evaluation, consisting of epileptiform activity on the EEG. Five (5%) patients had recurrent seizures during admission, three of them without risk factors during the ER evaluation.
Risk factors for seizure recurrence were detected during admission in nearly a quarter of the patients who presented to the emergency room with a first unprovoked seizure. Because the main advantage of admission is the EEG recording, we suggest that an early EEG should be obtained in these patients either during admission or through a special accelerated outpatient arrangement.