Emergency Department Electroencephalography for First-Time Seizure

The current standard of care for first-time unprovoked seizure in patients presenting to the emergency department (ED) is to obtain a head computed tomography scan or arrange for one to be performed within a few days, obtain electrolyte levels, and discharge the patient without a prescription if no cause is found. The patient is referred to a neurologist, who typically will arrange an electroencephalogram (EEG) and possibly further imaging. For patients presenting with a non–first-time unprovoked seizure who have not yet had an EEG, the standard of care is not clear, and many emergency physicians would consider immediate neurological consultation or empiric treatment with an anticonvulsant.

These investigators report results from a prospecti…