Overview
How frequently are first adult seizures misdiagnosed?
What is the stepwise approach to evaluation of first adult seizure?
How are epileptic seizures defined?
How are symptomatic (nonepileptic) seizures defined?
What topics are related to first adult seizure?
What are the causes of first seizure in adults?
What are risk factors for recurrent adult seizures?
What are the recurrence risks for adult seizures in patients with epileptiform discharges on EEG?
What is the incidence of first adult seizure?
What is the prognosis of first adult seizure?
What is the recurrence rate following first adult seizure and which factors increase risk?
What should be included in patient information about first adult seizure?
Presentation
What are the signs and symptoms of aura in first adult seizure?
What should be the focus of clinical history in the evaluation of first adult seizure?
How is syncope differentiated from first adult seizure?
What should be the focus of the neurologic exam for first adult seizure?
DDX
Why can’t first adult seizure be diagnosed as epilepsy?
What other conditions may be considered in the differential diagnoses of first adult seizure?
What are the differential diagnoses for First Adult Seizure?
Workup
Which lab and imaging studies are included in the workup of first adult seizure?
What is the role of imaging in the diagnosis of first adult seizure?
What is the role of EEG in the diagnosis of first adult seizure?
What is the indication for an insertable loop recorder in the evaluation of first adult seizure?
Treatment
What are the treatment options for first adult seizure?
What is the role of anticonvulsant therapy in the treatment of first adult seizure?
Medications
Which medications are used in the treatment of first adult seizure?
Which anticonvulsants are used for the treatment of first adult seizure?
What is the safety and tolerability of anticonvulsants for the treatment of first adult seizure?
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An electroencephalogram (EEG) recording of a temporal lobe seizure. The ictal EEG pattern is shown in the rectangular areas.
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An electroencephalogram (EEG) recording from a patient with primary generalized epilepsy. A burst of bilateral spike and wave discharge is shown in the rectangular area.
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An electroencephalogram (EEG) recording of a seizure from a subdural array in a patient evaluated for epilepsy surgery. The subdural electrodes record from the left anterior temporal (LAT), left middle temporal (LMT), and left posterior temporal (LPT) regions. The EEG seizure pattern is seen best in bipolar EEG channels LAT 3-4 and LMT 3-4 (rectangular areas).