Convulsion

Electroencephalography.

For adults presenting with an apparent unprovoked first seizure, analysis of the evidence from 1 Class I and 10 Class II studies indicates that the EEG is probably helpful.It has a substantial yield with about 29% of EEGs demonstrating significant abnormalities,25,26 and these abnormalities predict the risk for seizure recurrence. In addition, EEG is regarded as astandard for the initial classification of seizures since it forms a basis for the “clinical and electroencephalographic classification of epileptic seizures.”25,26
Recommendations.
1. The EEG (routine)should be considered as part of the neurodiagnostic evaluation of the adult with an apparent unprovoked first seizure because it has a substantial yield (Level B).8,25,26
2. The EEG (routine) shouldbe considered as part of the neurodiagnostic evaluation of the adult with an apparent unprovoked first seizure because it has value in determining the risk for seizure recurrence (Level B).Electroencephalography.
For adults presenting initially with an apparent unprovoked first seizure, the evidence from seven Class II studies indicates that a brain imaging study, either a CT or MRI, isprobably useful. It has a significant yield of about 10%, which may lead to the diagnosis of disorders such as a brain tumor, stroke, cysticercosis, or other structural lesions, and may have some value indetermining the risk for seizure recurrence.
Recommendation.
Brain imaging using CT or MRI should be considered as part of the neurodiagnostic evaluation of adults presenting with an apparentunprovoked first seizure (Level B).
Laboratory studies.
Data from two Class II and four Class III studies showed that in adults presenting with an apparent unprovoked first seizure, although someabnormal laboratory results are reported, there is not sufficient evidence to support or refute recommending routine testing of blood glucose, blood counts, or electrolyte panels. The necessity for such...