What should be the focus of clinical history in the evaluation of 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

The following information should be obtained in the history:

  • Record the patient's age.

  • If a family history of seizures is noted, determine the clinical epilepsy syndrome of the affected family member.

  • Ask about a history of any previous provoked seizure.

  • Determine if the first seizure was status epilepticus.

  • Ask the time of day of the seizure occurrence.

  • Determine whether there is a history of postictal confusion, incontinence, and occurrence out of sleep.

  • Psychogenic nonepileptic attacks (PNEAs) are the most common nonepileptic events seen in referral epilepsy centers but should only be considered in the setting of recurrent episodes. [2]

  • Seek a possible cause (see Etiology).

  • Consider other paroxysmal neurologic events and identify seizure mimics, such as syncope, transient ischemic attack, transient global amnesia, migraine, sleep disorder, movement disorder, and vertigo. [28]


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