OBJECTIVE To provide evidence-based recommendations for treatment of adults with an unprovoked first seizure. METHODS We defined relevant questions and systematically reviewed published studies according to the American Academy of Neurology's classification of evidence criteria; we based recommendations on evidence level. RESULTS AND RECOMMENDATIONS Adults with an unprovoked first seizure s...

Background: A seizure occurs as result of a sudden and transitory abnormal electrical brain activity, that causes variety changes on behavior, movements level consciousness. After first unprovoked seizure, the risk recurrence in three following years varies from 23 to 71%. The after more than 24 hours defines diagnosis Epilepsy, which has numerous biological, cognitive, psychological social con...

OBJECTIVE To determine for how long after a first unprovoked seizure a driver must be seizure-free before the risk of recurrence in the next 12 months falls below 20%, enabling them to regain their driving licence. DESIGN Randomised controlled trial: Multicentre study of early Epilepsy and Single Seizures (MESS). SETTING UK hospital outpatient clinics from 1 January 1993 to 31 December 2000...

The risk of recurrence after a first unprovoked seizure has been examined in numerous observational studies and two large, high-quality randomized trials. Overall, in untreated individuals, 40-50% can expect a recurrence within 2 years of the initial seizure. Treatment may reduce this risk by as much as half. Those at the greatest risk of recurrence have either an abnormal EEG or an identifiabl...

In a prospective study, 283 children who presented with a first unprovoked seizure were followed for a mean of 30 months from the time of first seizure. Subsequent seizures were experienced by 101 children (36%). The cumulative risk of seizure recurrence for the entire study group was 26% at 12 months, 36% at 24 months, 40% at 36 months, and 42% at 48 months. The cumulative risk of recurrence i...

OBJECTIVE Genetically tractable fruit flies have been used for decades to study seizure disorders. However, there is a paucity of data specifically correlating fly and human seizure phenotypes. We have previously shown that mutation of orthologous PRICKLE genes from flies to humans produce seizures. This study aimed to determine whether the prickle-mediated seizure phenotypes in flies closely p...

Introduction Single unprovoked seizures occur in about 4% of the population and they have significant psychosocial consequences for the patients and their families. Little information is available on the timeliness and safety of assessment of first unprovoked seizures. In this study, we review the timeliness of the referral and evaluation of patients with first unprovoked seizure in a Canadian ...