title: [Management of a first epileptic seizure in adults].
abstract: Management of a first seizure is a frequent challenge in the emergency room. Definite diagnosis is mandatory before treatment, identification of the epileptic syndrome is recommended. The overall recurrence rate of a first unprovoked seizure is about 50%, but varies considerably depending on several risk factors (neurological deficit in particular, a congenital one, Todd's paralysis, significant psychiatric disorders, epilepsy in siblings, symptomatic seizures (MRI is the standard procedure now to detect a structural lesion, except in case of a idiopathic generalised epilepsy and epilepsy with centro-temporal spikes) and epileptiform abnormalities on EEG which should be obtained within 24 hours after a seizure. Each treatment decision has to be taken individually after discussion with the patient. Early treatment reduces the 2 years recurrence rate but doesn't alter the long term prognosis.
authors.affiliation: Service de neurochirurgie, hôpital Sainte-Anne, 75014 Paris. m.mann@ch-sainte-anne.fr
authors.forename: Michael W
authors.initials: MW
authors.lastname: Mann
mesh_terms: D000328:Adult; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans