Seizure secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]


Patients that have had a first seizure should be counseled for their seizure episode and the possible etiology, lifestyle modifications (safety measures and avoidance of the factors that can lower the seizure threshold and predispose to recurrences, such as sleep deprivation, use of alcohol, and illicit drugs), driving, antiepileptic drugs (AED) and their side effects, and follow-up. Patients, family members, friends, and co-workers should be counseled for seizure first aid during a seizure event such as removal of harmful objects, repositioning the patient in order to support breathing, timing the seizure, calling for help, not restraining or holding the patient down, and not putting anything in the patient's mouth.

Secondary Prevention

Patients that have had a first seizures should be counseled for:[1]

  • What a seizure is and the possible etiology
  • Lifestyle modification:
    • Safety measures such as cooking, exercising, and work-related activities
    • Avoidance of the factors that can lower the seizure threshold and predispose to recurrences, such as sleep deprivation, use of alcohol, and illicit drugs
  • Driving
    • The requirements and limitations may differ in different individuals
  • Seizure first aid (patients, family members, friends, and co-workers):
    • Removal of harmful objects
    • Comfort pillow under the head, loosen tight clothing, remove eyeglasses
    • Reposition the patient in order to support breathing
    • Stay with the patients until the end of the seizure
    • Time the seizure
    • Call for emergency help
    • Do not restrain or hold the patient down
    • Do not put anything in the patient's mouth
  • Role of antiepileptic drugs (AED) if required, and their actions and side effects
  • Psychological implications (cognitive and emotional)
  • Follow-up and when to call for help


  1. Legg KT, Newton M (2017). "Counselling adults who experience a first seizure". Seizure. 49: 64–68. doi:10.1016/j.seizure.2016.09.012. PMID 27720347.