Experience the Clinical Debate: AGAINST- Should Epilepsy be Diagnosed (and/or Treated) after A Single Seizure has Occurred?

A single seizure may be the first warning of epilepsy, and the conceptual approach to diagnose and treat epilepsy is important. There is considerable disagreement about the recurrence risk and start of anti-epileptic drug following a first seizure as the diagnosis of epilepsy after a single unprovoked seizure can have serious negative consequences on the psychosocial status of the patient. However, the consequences of a recurrence vary between individuals in different geographical areas and social situations. The following presentation details the demerits of diagnosis of epilepsy after first seizure as most seizures with normal imaging and EEG are unlikely to recur in the patient. Thus, the question arises, whether it is justified for the clinicians to start antiepileptics, which would mean exposing the patients to adverse effects, especially in vulnerable populations (children, women, etc.)