ArticleNeurological research and practice2019
SOP: First-ever epileptic seizure in adult patients.
Article in Neurological research and practice, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
2 citing papers in PubMed.
- Mind the guideline gap: emergent CT in patients with epilepsy for trauma rule-out-A retrospective cohort study.Neurological research and practice · 2025Article
- Neurological research and practice: the first year.Neurological research and practice · 2020Article
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAbout 5% of all adults will have at least one epileptic seizure in their life. The incidence of all unprovoked seizures ranges from approximately 50 to 70 /100,000. The very first epileptic seizure in an adult can be a very decisive event and demands a great deal of responsibility on the part of the treating clinician. Optimal clinical work-up and systematic decision-making are necessary to ensure adequate treatment as well as to avoid unnecessary treatment, such as life-long application of anticonvulsants that may not be indicated.
aimTo present a pragmatic standard operating procedure (SOP) for approaching the first seizure in adults.
methodBased on current recommendations and personal suggestions, an SOP in the form of a flow chart accompanied with topical explanations and tables was created.
resultsApproaching the first seizure should start with obtaining bystander information on the seizure and its clinical features. Then, differential diagnoses should be considered. The diagnostic work-up hast to contain a neurological and physical examination, emergency blood tests and cerebral imaging. This should allow to differentiate an unprovoked from an acute symptomatic seizure, i.e. triggered by current specific and identifiable structural or metabolic cause that should be eliminated if possible. In the case of an unprovoked seizure, estimation of seizure recurrence is necessary for the decision to start treatment with antiepileptic drugs.
conclusionThe challenge of diagnostic work-up and treatment decisions after a first epileptic seizure in adults may be facilitated by a systematic, SOP-based approach.
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Registered trials
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