title: Utility of hospitalization following a first unprovoked seizure.
abstract: OBJECTIVE
  Hospital admission in otherwise healthy patients following a first unprovoked seizure is controversial. We aimed to evaluate the influence of admission in a neurology department on the identification of risk factors for seizure recurrence in patients with a first unprovoked seizure.
  
  
  METHODS
  We retrospectively reviewed the medical records of patients with a first unprovoked seizure, who were admitted to the neurology departments at two medical centers between 2007 and 2009. Risk factors for seizure recurrence included the following: abnormal neurological examination, abnormal brain CT scan, and epileptiform discharges on the EEG.
  
  
  RESULTS
  The study group included 97 patients (52 men) aged 18-85 years (mean 42). Eighty-seven (90%) patients were admitted following a generalized tonic-clonic seizure. Risk factors were identified in the emergency room (ER) in 36 (37%) patients, mainly including abnormalities of the neurological examination and brain CT scan. Nineteen (20%) patients had a risk factor which was not apparent during ER evaluation, consisting of epileptiform activity on the EEG. Five (5%) patients had recurrent seizures during admission, three of them without risk factors during the ER evaluation.
  
  
  CONCLUSIONS
  Risk factors for seizure recurrence were detected during admission in nearly a quarter of the patients who presented to the emergency room with a first unprovoked seizure. Because the main advantage of admission is the EEG recording, we suggest that an early EEG should be obtained in these patients either during admission or through a special accelerated outpatient arrangement.
authors: EEG and Epilepsy Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors: I
authors: I
authors: Goldberg
authors: M Y
authors: MY
authors: Neufeld
authors: E
authors: E
authors: Auriel
authors: R
authors: R
authors: Gandelman-Marton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004569:Electroencephalography; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D055815:Young Adult