Utility of hospitalization following a first unprovoked seizure

I. Goldberg, M. Y. Neufeld, E. Auriel, R. Gandelman-Marton*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: 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. Results: 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. Conclusions: 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.

Original languageEnglish
Pages (from-to)61-64
Number of pages4
JournalActa Neurologica Scandinavica
Volume128
Issue number1
DOIs
StatePublished - Jul 2013

Keywords

  • First seizure
  • Hospitalization
  • Seizure recurrence

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