Should People Be Treated After a First Seizure?

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Abstract
The occurrence of a seizure is a frightening event, both for the individual affected and for those who witness the episode. If medical attention is sought, the clinician must determine both the potential underlying or precipitating cause of the event and decide what therapeutic intervention, if any, is warranted. In general, the latter decision is based on the former determination. In situations in which a clearly remediable cause of seizures is identified, the need for short- or long-term therapy with anticonvulsant drugs (ACDs) may be less important than the need for timely intervention to remedy the primary problem. When no potentially remediable metabolic or structural abnormality is identified, the clinician is still faced with a decision of whether to recommend short- or long-term ACD therapy. It should be clear that the potential for benefit of the therapy should exceed the risk associated with initiation of the therapy. Thus, the frequency