First Seizure Clinic

• Inclusion criteria: adult patients (18 years or older) with first unprovoked seizure – no prior history of seizures

  • *Make sure patient was questioned about premonitory symptoms, aura, deja vu, olfactory hallucinations, epigastric rising sensations, paroxysmal autonomic changes, warnings of seizures, loss of awareness, staring spells, morning myoclonus, amnesias, confusion upon awakening, unexplained tongue lacerations or nocturnal enuresis. 

• Patient typically seen within 1-2 weeks of referral.  They will have an MRI and EEG in the morning and clinic visit in the afternoon with an epileptologist.

• If neurology is consulted in ED or trauma unit and feels appropriate for first seizure clinic then

  • Neurology resident orders MRI and EEG, update ED team about orders

    • To order MRI and EEG, under plan and smart sets search AMB Gen Neuro Epilepsy Orders.  Order EEG – 1 hour EEG listed in comments already and MRI brain temp lobe W/O contrast. 

    • If there is an indication to use MRI with contrast, please order study with contrast and let epilepsy team know in EPIC group message.

  • Send epic group/pooled message to UMMC neurology first seizure to notify epilepsy team about referral to first seizure clinic

  • Include EPIC smartphrase .firstseizure (shared with chiefs)

  • Discuss driving laws and not driving with patient

  • If any additional seizure, counsel patient to return to ED

Last Updated: April 13, 2023