First Seizure

Question 1

History

Answer 1

• Witness
• What were they doing at the time
• Movement, responsiveness, tongue biting, eyes, frothing, incontinence
• Duration
• Self-termination?
• Post-ictal phase
• Preceding symptoms
• Head injury? Vomiting? Concurrent illness?
• Previous seizures/ family history

Question 2

Social History

Answer 2

Occupation/ hobbies
Drugs and alcohol
Driving

Question 3

Examination

Answer 3

Full neurological examination + cognition

Question 4

Investigations

Answer 4

FBC, U&Es, CT Head (if not young)… may need EEG

Question 5

Follow up

Answer 5

First seizure clinic. No need for medication at this stage.

Question 6

Precautions

Answer 6

1) No driving for at least 6 months or until advice can do so by neurologist. Patient must inform DVLA
2) No climbing/ fire equipment/ swimming unsupervised/ operating heavy machinery
3) What to do if further seizures - advice to the family