Patients are assessed when they have had a first seizure to understand:

• Risk factors such as seizure triggers and family history
• Symptoms of auras including unexpected tastes, smells, paraesthesia, or a rising abdominal sensation
• Features of seizures and symptoms following an attack (e.g. drowsiness, amnesia, injury, aching limbs or headaches)
• Baseline tests such as full blood count, kidney and liver function tests, glucose, calcium and an EEG are usually carried out.

Identifying people who have epilepsy is difficult, however referring for early diagnosis is important. All people suspected of having a first epileptic seizure should be referred to a specialist for confirmation of the diagnosis and initiation of treatment.

The risk of recurrent seizures is highest in the first 12 months, falling to less than 10 per cent after two years. Some people who have no seizures for more than two years can often have their medicine withdrawn, but there may be an increased risk of seizures happening again.