Diagnostic Factors in Adult Males Following Initial Seizures

Seventy-seven navy enlisted men with a mean age of 23.2 years (range, 17 of 48) were admitted to the hospital after their first seizure and given a provisional diagnosis of convulsive disorder. The subjects were followed-up for three years to see if reliable predictors of subsequent seizures and diagnosis could be obtained at the first examination. If not readmitted because of a second seizure, each patient was recalled at the end of his first and third year in the study for follow-up examinations. Following a second seizure and readmission to the hospital, 39% were diagnosed as having a convulsive disorder, 18% a psychiatric disorder, and 5% a neurological illness. Thirty-six percent never had a second seizure. Of those experiencing a second seizure 77% were readmitted during the first year. Three variables were used as predictors of second seizures and final diagnoses: type of seizure (major motor); electroencephalographic classification (spikes with or without slow waves); and presence of postictal confusion and disorientation.