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Year : 2021  |  Volume : 5  |  Issue : 1  |  Page : 39

First epileptic seizure and electroencephalography: An overview

Department of Medicine, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil

Date of Submission14-Jan-2021
Date of Acceptance19-Jan-2021
Date of Web Publication10-Apr-2021

Correspondence Address:
Dr. Jamir Pitton Rissardo
Rua Roraima, Santa Maria, Rio Grande do Sul
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/LJMS.LJMS_4_21

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How to cite this article:
Rissardo JP, Fornari Caprara AL. First epileptic seizure and electroencephalography: An overview. Libyan J Med Sci 2021;5:39

How to cite this URL:
Rissardo JP, Fornari Caprara AL. First epileptic seizure and electroencephalography: An overview. Libyan J Med Sci [serial online] 2021 [cited 2023 Mar 27];5:39. Available from: https://www.ljmsonline.com/text.asp?2021/5/1/39/313523

Dear Editor,

We read the article “Management of First Seizure: An Inductive Reading to the Local Clinical Parameters among Libyan Doctors” on the esteemed “Libyan Journal of Medical Sciences” with great interest. Rajab et al. aimed to provide the data as well as to assess their local clinical practice parameters regarding the management of patients with first-onset seizure. They observed that the findings were partly in agreement with evidence-based practice, but a larger and more constructed study is warranted.[1] Here, we would like to highlight some important topics that together with the study of Rajab et al. could lead to a better comprehension of the electroencephalogram (EEG) and brain imaging roles in the first unprovoked seizure (FUS).

Albrecht and Markus reviewed the past 5 years of the literature about the first-ever seizure discussing the epileptic diagnosis and best management after the event. They conclude even though there are many imaging or electrodiagnostic studies the anamnesis continues to consider the most important tool in the FUS diagnosis. Moreover, the study found that the cause is the central key to the risk of recurrent episodes. However, they conclude that there is no current way to precisely determine the individualized recurrence risk.[2]

Another study of the Complejo Hospitalario Toledo–Leonardo Torres Vera in Spain produced a protocol for a first epileptic seizure. The protocol was based on three steps: First, the filling of a form and a neurologist evaluation. After the case is analyzed by a team and an EEG is programmed to do within 24–48 h of the admission. Later, the patient is scheduled for an outpatient visit within 1 week by an expert. An interesting result was that the EEG within 2 days of the event is essential for the diagnosis of epilepsy.[3]

Sartori et al. performed a retrospective study of infants presenting with a first-ever seizure in a tertiary-care pediatric emergency department in a European country. They conclude that a neurological follow-up should be performed mainly when there are one or more risk factors. The factors encountered were the first event be unprovoked, children older than 6-year-old, previous neurological disease, and event with focal onset.[4]

Holper et al. compared FUS subjects and recurrent-untreated seizures (RUS) individuals. Their results were that RUS more commonly have a more predictable semiology and more frequently have normal neuroimaging and electrodiagnostic studies than patients with FUS. Furthermore, RUS individuals tend to receive more inpatient investigations, antiepileptic drug prescriptions, and a lengthier neurological follow-up than the FUS subjects.[5]

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Conflicts of interest

There are no conflicts of interest.

  References Top

Rajab AM, Bennour AM, Lawgaly SA. Management of first seizure: An inductive reading to the local clinical parameters among Libyan doctors. Libyan J Med Sci 2020;4:125-8.  Back to cited text no. 1
  [Full text]  
Kunze A, Reuber M. The first seizure as an indicator of epilepsy. Curr Opin Neurol 2018;31:156-61.  Back to cited text no. 2
Vera LT, Azcona AT, Loro FA, Brazo CA, Castillo RA, Álvarez CI. P03-F Early care protocol for patients with a first epileptic seizure in the Complejo Hospitalario Toledo. Clin Neurophysiol 2019;130:e67.  Back to cited text no. 3
Sartori S, Nosadini M, Tessarin G, Boniver C, Frigo AC, Toldo I, et al. First-ever convulsive seizures in children presenting to the emergency department: Risk factors for seizure recurrence and diagnosis of epilepsy. Dev Med Child Neurol 2019;61:82-90.  Back to cited text no. 4
Holper S, Foster E, Kwan P. First come, first served: A comparison of first-ever seizure patients and those presenting after recurrent-untreated seizures. J Neurol Neurosurgery Psychiatry 2018;89:107.  Back to cited text no. 5


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