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Epidemiology, clinical characteristics, and management of adults referred to a teaching hospital first seizure clinic

¹ Department of General Surgery, Borders General Hospital, Melrose, Scotland
² Emergency Department, The Royal Infirmary of Edinburgh at Little France, Edinburgh, Scotland
³ Department of Clinical Neurosciences, Western General Hospital, Edinburgh, Scotland

Correspondence to:
Correspondence to:
Dr D P Breen
Department of General Surgery, Borders General Hospital, Melrose TD6 9BS, Scotland; davebreen{at}lycos.com

Background: There are scarce data describing the epidemiology, clinical characteristics, and management of adults who suffer a suspected first seizure.

Aim: 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.

Design: 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).

Conclusion: 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.

Keywords: seizure; epidemiology; adult