Epidemiology, clinical characteristics, and management of adults referred to a teaching hospital first seizure clinic.
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.
Breen
D P
DP
Department of General Surgery, Borders General Hospital, Melrose, Scotland. davebreen@lycos.com
Dunn
M J G
MJ
Davenport
R J
RJ
Gray
A J
AJ
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