First Time Seizure

The first time a person has a seizure, it can be quite frightening.  It helps to know what safety measures to take when a person is having a seizure.   See this link for first aid instructions for a seizure.

It is important to seek medical attention after a first time seizure.  Some of the causes of a seizure (infection, hypoglycemia, hyponatremia, hypokalemia) may be dangerous and may require immediate treatment.  These can be evaluated by tests.

A referral to a neurologist is a good idea after a first time seizure.  They will probably use EEG and MRI tests to help decide how likely another seizure will occur.  Both of these tests can be normal for a person who has had a seizure.   Healthy people with a single seizure and normal tests are not likely to have another seizure, and they may not need any treatment.

For safety reasons, people who have had a seizure should refrain from driving, swimming, and climbing ladders until doctors are sure it is safe to return.  Different parts of the world have different laws about how long to refrain from driving.

Benign Rolandic Epilepsy

Benign Rolandic Epilepsy, or BRE, is a condition that affects young children, generally between the ages of 3-13.  Most children outgrow this condition.  Seizures that occur in this condition originate around the central sulcus, an area of the brain between the motor activation and sensory cortical areas.  Symptoms of a BRE seizure are excessive salivation, cessation of speech, abnormal movements of the muscles around the mouth and lips, or movement of facial expression on one side of the face.  Not all patients with this condition experience all of these symptoms.  Unlike many other types of seizures, consciousness may be preserved during a BRE seizure, and patients may sometimes be able to describe how they feel.

Patients with this condition tend to have a specific EEG abnormality not found in other epilepsy conditions.  These are centrotemporal spike waves.  These should be observed whether the patient is having a seizure or not.  It is rare that MRI testing is helpful in this condition.

Most cases of BRE resolve spontaneously within 2-4 years.  The frequency of seizures is low and treatment is usually not needed.  For cases where seizures are frequent, or in cases when intellectual development is not normal, the label “benign” is removed, and the term “rolandic epilepsy” is used.  Medical treatment is helpful in some cases.  Very few people with Rolandic epilepsy continue to have seizures in their adult years.