First Time Seizure in an Adult

NOTE: This pathway is intended for the clinical scenario where the clinical suspicion for seizure is relatively high. If there is uncertainty regarding the episode(s) in question consider utilizing the seizure versus syncope pathway. Evaluation of a first-time seizure-like event begins with careful characterization of the event. Many paroxysmal events that appear to be seizures are actually convulsive syncope, psychogenic events, or other non-epileptic conditions. The goal of the history is to determine whether the event was truly epileptic, identify possible provoking factors, and guide the initial diagnostic workup.