ECG in all cases (Troponins if doubt about seizure from collateral history); confirm QT interval. If seizure occurred in setting of heavy alcohol intake, request Alcohol Counselling service assessment.
Consider CDU (EM consultant) or medical admission if alcoholism, poor social circumstances or those without a responsible adult to stay with. ECG in all cases (troponins if doubt about seizure from collateral history); confirm QT interval.
If a convulsive seizure (particularly if >2 minutes) start Levetiracetam 250mg bid a 1 week, then increase to 500mg bid (Dr. Consider giving family a prescription for PRN buccal midazolam 10mg if patient presents with 1st prolonged convulsion.


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Having had a seizure should not stop patients from doing the things they enjoy, although sensible safety precautions do need to be taken.
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They should be advised not to swim alone, not to lock the bathroom door when bathing, or bathing infants alone.
Some (unprovoked) can resume driving after six months (of seizure free) but will require detailed assessment by a neurologist.



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