Experiencing a seizure for the first time can be frightening and confusing. Whether it happens to you, your child or someone close to you, you may be left with questions: Was it definitely a seizure? What caused it? Could it happen again? Does it mean epilepsy? And what happens next?
A first seizure does not necessarily mean that someone has epilepsy. There are a number of reasons why someone may experience a seizure-like episode or loss of consciousness, which is why a thorough medical assessment is important.
If you or your child has experienced a suspected first seizure, a specialist assessment can help establish what may have happened and whether further investigation is needed.
What is a first seizure?
A seizure occurs when there is a sudden burst of abnormal electrical activity in the brain. Seizures can affect people in different ways, and the symptoms aren’t always the dramatic shaking or loss of consciousness that many people associate with epilepsy.
Depending on the type of seizure, someone may experience:
- Sudden jerking or shaking movements
- Stiffness
- Loss of consciousness
- Staring or “blank” episodes
- Temporary confusion or altered awareness
- Unusual movements or sensations
- A period of confusion or tiredness afterwards
- Episodes that occur during sleep
Some episodes that look like seizures can have other causes, which is why an accurate description of what happened is an important part of the assessment.
Does one seizure mean you have epilepsy?
No. Having a single seizure does not automatically mean that you have epilepsy.
Epilepsy is a neurological condition characterised by a tendency to have recurrent unprovoked seizures. Your consultant will consider a range of information before deciding whether your symptoms are consistent with epilepsy or another condition.
This can include your medical history, what happened before, during and after the episode, your clinical examination and, where appropriate, investigations such as an EEG.
This is why a specialist assessment following a first suspected seizure can be so valuable.
What happens after a first seizure?
Following a suspected seizure, your healthcare professional will usually want to understand exactly what happened.
You may be asked questions such as:
- What were you doing immediately before the episode?
- Did you experience any warning symptoms?
- Did you lose consciousness?
- How long did the episode appear to last?
- Were there any unusual movements?
- Did you appear confused during or afterwards?
- How did you feel after the episode?
- Has anything similar happened before?
- Were you taking any medication at the time?
- Did the episode happen while you were awake or asleep?
If someone witnessed the episode, their description can be extremely useful. If it was safe and appropriate to record a future episode, a video can also provide valuable information for a specialist.
What is an EEG?
An electroencephalogram, commonly known as an EEG, is a test that records the brain’s natural electrical activity.
During an EEG, small sensors called electrodes are gently attached to the scalp. These detect electrical activity in the brain and record it as wave patterns that can be reviewed by a trained neurophysiology professional and consultant.
An EEG is:
- Non-invasive
- Painless
- Free from radiation
- Not performed using needles
- Not an electrical shock or treatment
Depending on the circumstances, an EEG may be performed while you are awake, sleepy or asleep.
Can an EEG diagnose epilepsy?
An EEG can provide important information when investigating suspected seizures and epilepsy, but an EEG does not diagnose epilepsy on its own.
A person with epilepsy can have a normal EEG between seizures. Equally, abnormal electrical activity can provide useful evidence to support a diagnosis when considered alongside the person’s symptoms, medical history and clinical examination.
This means that your consultant will consider your EEG results as part of the wider assessment rather than relying on the test alone.
What if the EEG is normal?
A normal EEG does not necessarily mean that you haven’t experienced a seizure or that epilepsy has been ruled out.
If your symptoms continue or your consultant believes further investigation is appropriate, they may discuss additional tests or monitoring with you. Depending on your individual circumstances, this could include further EEG monitoring or brain imaging such as an MRI.
Your consultant will explain why additional investigations may be recommended and what they could help establish.
What should you take to a seizure assessment?
If you’re attending an appointment following a suspected seizure, providing as much information as possible can help your consultant understand what happened.
If possible, consider bringing:
- Someone who witnessed the episode
- A written description of what happened
- Details of any previous similar episodes
- Information about your current medications
- Details of any relevant medical conditions
- Previous test results or medical letters
- A video recording of an episode, if one was safely captured
For children, it can be particularly helpful for a parent, guardian or another person who witnessed the event to attend the appointment.
What about driving after a seizure?
If you’ve experienced a seizure, there are important considerations around driving.
In the UK, you must stop driving and notify the DVLA if you’ve had a seizure. The length of time you need to stop driving depends on the circumstances and the risk of another seizure.
The rules can be complicated, so you should check the current DVLA guidance and discuss your individual circumstances with an appropriate healthcare professional.
A specialist assessment can help you understand what your symptoms and test results may mean, including any implications for driving.
What happens at a First Seizure Clinic?
A First Seizure Clinic brings together specialist neurological assessment and appropriate diagnostic testing to investigate a suspected seizure or unexplained neurological episode.
At Midland Health, the First Seizure Clinic is available for adults and children who have experienced a possible first seizure, unexplained blackout or collapse, staring episodes, sudden jerking movements, altered awareness or other symptoms that may require neurological investigation.
The service combines an EEG with assessment by an experienced consultant. The EEG is carried out by a specialist neurophysiology professional, and the consultant reviews the results alongside your symptoms, medical history and clinical examination.
This joined-up approach can help provide a clearer understanding of what may have happened and what the next steps in your care should be.
What happens after the assessment?
Once your assessment and investigations have been completed, your consultant will explain the findings and discuss what they mean for you.
Depending on the outcome, you may be advised that no further investigation is required, or your consultant may recommend additional tests, treatment, monitoring or referral to another specialist service.
Where appropriate, Midland Health can also communicate with your GP or NHS team, helping to ensure that your care remains coordinated.
When should you seek urgent medical help?
A suspected seizure should always be taken seriously, particularly if it is the first time it has happened.
You should seek urgent medical help if a seizure lasts longer than usual, another seizure occurs before the person has recovered, the person is seriously injured, has difficulty breathing afterwards, or you are otherwise seriously concerned about their condition.
A First Seizure Clinic is intended for assessment after an event and is not a replacement for emergency medical care.
Getting answers after a first seizure
Experiencing a first seizure or unexplained neurological episode can leave you with a lot of uncertainty. While one seizure does not necessarily mean epilepsy, understanding what happened and whether further investigation is needed can provide reassurance and help you make informed decisions about your health.
A specialist assessment can bring together your symptoms, medical history, clinical examination and appropriate diagnostic testing such as an EEG to build a clearer picture of what may be happening.
First Seizure Clinic at Midland Health
Midland Health’s First Seizure Clinic provides specialist assessment for adults and children following a suspected first seizure or unexplained neurological episode.
The service combines an EEG with consultant assessment, with further investigations or treatment recommendations made where clinically appropriate. No GP referral is required to book the service, and Midland Health can liaise with your GP or NHS team where appropriate.
If you or your child has experienced a suspected first seizure, unexplained blackout, collapse, staring episode or other concerning neurological symptoms, you can find out more about Midland Health’s First Seizure Clinic, EEG and Seizure Assessment.
