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First Unprovoked Seizure – Recurrence Risk — SCE Neurology MCQ

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ModerateEpilepsy & Seizure DisordersFirst Unprovoked Seizure – Recurrence RiskSCE Neurology

A 38-year-old man presents with a first generalised tonic-clonic seizure. Investigations reveal a normal MRI brain and a normal interictal EEG. He asks about the risk of seizure recurrence. What is the approximate probability of a further unprovoked seizure within 2 years?

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Correct answer: C — 40–50%

The best answer is “40–50%”. NICE bases epilepsy diagnosis and treatment on seizure type, syndrome, recurrence risk, comorbidity, pregnancy potential and medicine harms; typical provoked seizures are managed by correcting the provoking cause. The alternatives “10–15%”, “20–30%”, “70–80%”, “>90%” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE NG217 epilepsy recommendations: https://www.nice.org.uk/guidance/ng217/chapter/Recommendations