title: Epidemiology, clinical characteristics, and management of adults referred to a teaching hospital first seizure clinic.
abstract: BACKGROUND
  There are scarce data describing the epidemiology, clinical characteristics, and management of adults who suffer a suspected first seizure.
  
  
  OBJECTIVE
  To describe the epidemiology, clinical characteristics, and management of adults with a suspected first seizure who are referred to a teaching hospital first seizure clinic over a one year period.
  
  
  METHODS
  Prospective descriptive study.
  
  
  METHODS
  Data were collected on consecutive adults referred to the Royal Infirmary of Edinburgh between 4 February 2003 and 10 February 2004.
  
  
  RESULTS
  232 patients were referred to the first seizure clinic. Median age was 32 years; 53% of patients were male. Lower socioeconomic groups were more likely to present with a suspected first seizure. Nineteen per cent of patients were admitted to hospital after their suspected seizure episode. Appropriate driving advice was reported in 64% of cases. Seventy two per cent of patients were offered a first seizure clinic appointment within six weeks of referral. Nine per cent of patients had a subsequent seizure while awaiting review. Fifty two per cent of patients were confirmed as having a first seizure at the clinic, of which 56% were provoked by alcohol, recreational drugs, or sleep deprivation. Electroencephalography and computed tomography of the brain were the most common investigations ordered at the first seizure clinic (22% and 22% of patients respectively).
  
  
  CONCLUSIONS
  Adults who suffer a suspected first seizure, and who make a full neurological recovery, can be safely managed as an outpatient. Around half of these patients will have a specialist diagnosis of first seizure and alcohol will be a common precipitating factor.
authors.affiliation: Department of General Surgery, Borders General Hospital, Melrose, Scotland. davebreen@lycos.com
authors.forename: D P
authors.initials: DP
authors.lastname: Breen
authors.forename: M J G
authors.initials: MJ
authors.lastname: Dunn
authors.forename: R J
authors.initials: RJ
authors.lastname: Davenport
authors.forename: A J
authors.initials: AJ
authors.lastname: Gray
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D004638:Emergency Treatment; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006784:Hospitals, Teaching; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation; D012640:Seizures / Q000453:epidemiology / Q000628:therapy*; D014057:Tomography, X-Ray Computed