First seizure in adults: a prospective study from the emergency department

Acta Neurol Scand. 1992 Aug;86(2):134-8. doi: 10.1111/j.1600-0404.1992.tb05054.x.


A prospective study of 98 consecutive adults with a first seizure to determine the most important etiological factors and the optimum diagnostics. 27 were thought to have cryptogenic seizures. Main causes of symptomatic seizures were: cerebral infarction, alcohol-withdrawal, CNS infections, tumors, vascular malformations, traumatism and miscellanea. Eight were infected by human immunodeficiency virus (HIV-1) representing 8.2% of all the patients with a first seizure and 20% of the 15-45-year age group. CT disclosed structural lesions in 33 cases. MRI in those with normal CT and no other explanation of seizure revealed additional lesions in 22.2%, but did not change management in any. We conclude that CT is essential in evaluation of adults with first seizure. MRI may be useful in selected cases. The HIV-infected now represent an important group with a first seizure.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alcoholism / complications
  • Brain Diseases / complications
  • Diagnosis, Differential
  • Emergencies*
  • Emergency Service, Hospital
  • Epilepsy / chemically induced
  • Epilepsy / etiology*
  • Female
  • HIV Infections / complications
  • HIV-1
  • Humans
  • Illicit Drugs / adverse effects
  • Male
  • Middle Aged
  • Neurologic Examination
  • Prospective Studies
  • Seizures / chemically induced
  • Seizures / etiology*
  • Substance-Related Disorders / complications


  • Illicit Drugs