What should be included in patient information about first adult seizure?

Updated: Nov 30, 2017
  • Author: Eissa Ibrahim AlEissa, MD, MBBS; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Counseling patients about driving after a first seizure revolves around 2 issues: the diagnosis and the chance of recurrence.

Patients who have had a single epileptic seizure are at increased risk of having a second seizure. Therefore, these individuals should be informed that they are at increased risk of injury to themselves or others if another seizure occurs. Risk of injury is especially important if patients are driving, operating dangerous machinery, or performing other activities that could put themselves or others at risk. These same concerns also apply to nonepileptic conditions such as syncope that might recur and put the patient or others at risk of injury. Document this discussion in the patient’s medical record.

The patient should be advised to contact the state agency that regulates driving privileges, as driving regulations vary from state to state. The restrictions sometimes apply to any alteration or loss of consciousness from any etiology. This discussion with the patient should also be documented in the medical record.

Patients with a first epileptic seizure and with risk factors such as remote symptomatic etiology or an electroencephalogram (EEG) with epileptiform discharges are at higher risk for a second seizure. Restrictions of hazardous activity should be more emphatic for these patients.

For patient education information, see the Brain and Nervous System Center, as well as Epilepsy.


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