Neurological Bulletin


Introduction Single unprovoked seizures occur in about 4% of the population and they have significant psychosocial consequences for the patients and their families. Little information is available on the timeliness and safety of assessment of first unprovoked seizures. In this study, we review the timeliness of the referral and evaluation of patients with first unprovoked seizure in a Canadian neurological provincial referral center.

Method Retrospective analysis of 51 patients over a 3.5 year period was performed and data were collected on patient demographics, date of event and time to evaluation by the epileptologist, evaluations completed, treatments initiated and patient outcomes.

Results We found that most patients were seen by the epileptologist within 6 months, there was only a 9% discrepancy in final diagnoses between the epileptologist and the referring physician, and there were no fatalities or serious complications in the patients we studied. However, a few patients waited very long periods before imaging and evaluation by the epileptologist, and restrictions on driving privileges were recommended in only 3% of the patients.

Conclusions We conclude that the referral process for a first unprovoked seizure is timely. Primary care providers need further education with regards to the consequences of seizures and some areas of the referral region need better access to imaging and epileptologists.


single seizure, first seizure, wait times, EEG, risk prediction

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