The first seizure that a patient experiences can be scary and confusing. The Epilepsy Foundation estimates that up to 3 million Americans have epilepsy and that one person in 26 will develop the neurological condition at some point. If you had your first seizure, you need to know what to expect and what to do after a seizure.
Board-certified internist and neurologist, Dr. Andrew N. Wilner wrote a book specifically for recently diagnosed epileptics. The book, entitled “Epilepsy: 199 Answers,” clarifies the basic questions most patients ask.
After the first seizure, patients can expect to have a clinical examination and neurological evaluation performed. Although these can be lengthy, it is imperative to find the root cause of the seizure. Sometimes the seizure can be ruled as a possible one-time incident due to medications or an extreme circumstance (heat stroke or sleep deprivation). Depending on the situation, lab tests and drug and alcohol screenings may be performed. Unfortunately, sometimes no cause can be found.
The Epilepsy Foundation states people are considered epileptics if they have suffered from at least one seizure, and the cause is unidentifiable and cannot be traced back to a specific condition (medications, extreme circumstance, or infection).
Neurologists may perform one or all three of the following tests to look for a root cause after a seizure:
- MRI (magnetic resonance imaging)
- EEG (electroencephalography)
- CAT or CT Scan (computed axial tomography)
These tests may be able to predict a strong possibility of another seizure.
If the likelihood of the patient experiencing recurring seizures is great, medication may be prescribed. However, most people opt-out of anti-seizure medication after only one seizure. To learn more about treatment, read our blog, "After the First Seizure: To Treat or not to Treat." The side effects of the prescription drug must be weighed against the benefit of using the medication to prevent another seizure. Sixty to seventy percent of patients taking medication are able to control their seizures well enough to resume their routine in life. Some patients may be able to discontinue medication after one year with no new seizures.
Whether or not a patient agrees to take medication to control seizures, the patient is asked to increase their own personal safety. Often, workers may be told not to operate heavy machinery, climb ladders, or drive for long lengths of time. Students and athletes may be advised to decrease participation in extreme sports. Restricted activities may be dependent on the country. Some countries require patients to cease driving automobiles until one year has passed without a seizure. In the U.S., each state has different laws. Be sure to check with your state’s licensing board.
Helpful Ideas after the First Seizure
Preparing the following lists in advance will assist others if a patient suffers a second seizure.
- Keep a health record with the date of the first seizure, the length of the seizure and any notes about the event.
- Create a list of all medications the patient takes and any tests that have been performed.
- Gather the phone numbers and websites of the pharmaceutical companies that make the patient’s medications. It may be necessary to contact them with questions.
Keep these lists handy especially when away from home or on vacation.
National Institute of Health, National Library of Medicine http://www.ncbi.nlm.nih.gov/pubmed/26222507
The Epilepsy Foundation http://www.epilepsy.com/start-here/about-epilepsy-basics
Wilner, Andrew N. “Epilepsy: 199 Answers”, 2008 Demos Medical Publishing, LLC, New York, NY. Sample pages: https://www.overdrive.com/media/231920/epilepsy-199-answers