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First afebrile seizure — DCH MCQ

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ModerateChronic conditionsFirst afebrile seizureDCH

A 10-year-old has a first afebrile generalised tonic-clonic seizure lasting 90 seconds. He recovers fully, glucose is normal and neurological examination is normal. What is the most appropriate investigation?

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Correct answer: A — Specialist assessment with EEG if epilepsy suspected

A first afebrile seizure should prompt specialist assessment; EEG is used when epilepsy is suspected but should be interpreted in clinical context. Immediate long-term medication is not usually started by a GP after one brief seizure without assessment. The pearl is to obtain a witness description and consider syncope mimics.

Reference: NICE NG217