Treating a First Seizure?
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þ Algorithm:
 - Classify into
  + idiopathic (no history to suggest preexisting reason for seizure, normal
    neuro exam) or
  + remote symptomatic (history consistent with old neuro injury or illness
    that might be a cause for seizures, or abnormal exam)
 - Idiopathic has 24% chance of two-year recurrence if normal EEG, 48% if EEG
   abnormal; refer for outpatient EEG but don't start anticonvulsant, allow
   private pysician to discuss with patient after EEG.
 - Remote symptomatic has 48% chance if EEG normal, and 65% if EEG abnormal;
   start on anticonvulsant and refer for outpatient EEG.
   [Tintinalli 4E p. 1031]
   [Berg AT, Shinar S. The risk of seizure recurrence following a first
   unprovoked seizure: Neurology 41:965, 1991.]