Topic Review - Newest First (only newest 5 are displayed)
nizam
Re: Treatment Options for Women with Epilepsy
I would disagree with the notion that the first seizure does not need investigations. If a person has a single unprovoked seizure, there is an approximately 30-40% chance of seizure recurrence over the next 5 years. If a person has 2 unprovoked seizures separated by time there is an approximate 73% chance of seizure recurrence over the next 5 years.Please see the reference
http://content.nejm.org/cgi/content/abstract/338/7/429?andorexacttitleabs=and&search_tab=articles&tocsectionid=Original
A single simple febrile seizure may not necessarily require further investigations. But, an adult presenting with a single unprovoked seizure should be investigated.
Nizam
[Edited by Nizam on 03-02-2007 at 05:40 PM GMT]
ikhan700
Re: Re: Treatment Options for Women with Epilepsy
Being a epileptologist I would not investigate the first seizure , since in most cases it could be the last one.
Multiple seizures need to be investigated.
Imran Khan
icumicuccu
Re: Treatment Options for Women with Epilepsy
differential diagnosis of a first seizure includes REm behavior disorder or parasomnias,Transient ischemic attack or transient global ischemia of presumably vascular etiology and migraine
amoung seizures there are true epliptiform seizures and physiologic non epileptic seizures.
diagnostic studies include electrolytes, test for porphyrias, hematology studies, renal function test and hematology studies.
LP, CT, EEG and MRI in selected cases
all the above mentioned concerns about antiepileptic medications are reasonable and i agree with mr nizams assessment
nizamahmed
Re: Treatment Options for Women with Epilepsy
Further investigations can be based on the history. Many a times a convulsive syncope is misdiagnosed as an epileptic seizure and if such episodes are recurrent a tilt table test is helpful. In the elderly an ECG or 24 hours holter monitoring can be helpful. Toxicology screen in selected patients can offer some very helpful information.
docosama
Re: Treatment Options for Women with Epilepsy
What are the investigations that should be carried out on a patient who presents with one fit?
Electrolytes, Calcium, Glucose,
CT-Scan brain with contrast
EEG
Is there any other also?
