![]() Patients with a normal neurologic examination, normal test results, and no structural brain disease do not require hospitalization or antiepileptic medications. The most common laboratory findings associated with a seizure are abnormal sodium and glucose levels. Magnetic resonance imaging is preferred over computed tomography except when acute intracranial bleeding is suspected. ![]() Neuroimaging also should be performed in children with risk factors such as head trauma, focal neurologic deficits, or a history of malignancy. Electroencephalography is recommended for patients presenting with a first seizure, and neuroimaging is recommended for adults. No single sign, symptom, or test clearly differentiates a seizure from a nonseizure event (e.g., syncope, pseudoseizure). ![]() The patient history and physical examination should direct the type and timing of laboratory and imaging studies. Seizure is a common presentation in the emergency care setting, and new-onset epilepsy is the most common cause of unprovoked seizures. ![]()
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