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First Time Seizure in Adults: Types, Causes, Symptoms, Treatment, Prognosis, Management

About First Time Seizure in Adults & Its Types

First time seizure in adults is an abrupt change in the normal electrical activity of the brain. When a seizure occurs, the brain cells rise uncontrollably to almost four times of the normal activity, affecting the behavior, thinking, movement or feeling of a person temporarily. The two major types of seizure include:

First Time Seizure in Adults: Types, Causes, Symptoms, Treatment, Prognosis, Management

Primary Generalized Seizure: In this type of seizure, the entire cerebral cortex gets affected. The abnormal firing of the brain cells happens on both sides of the brain at the same time.

Partial or Focal Seizure: The abnormal firing of the brain cells starts at one area of the brain and remains there only.

Causes of First Time Seizure in Adults

There are many conditions that can affect the brain and cause the first time seizure, like the following:

  • Metabolic problems
  • Brain injury, before or after birth
  • Infections such as meningitis and encephalitis
  • Genetic conditions like tuberous sclerosis
  • Abnormal structures in the blood vessels of the brain
  • Eating or drinking toxic substances

Seizure is common and a person can have one seizure without recurrence. In case of epilepsy, seizures continue to recur.

Symptoms of First Time Seizure in Adults

The symptoms are different for different primary generalized seizures. These are:

Generalized Tonic-Clonic Seizure: In this, a person loses consciousness and falls on the floor. The body muscles contract all at once as a sustained contraction or contracts with shorter rhythmic contractions serially or both. Some even lose bowel and bladder control. This remains for less than one minute and a period of temporary confusion and lethargy follows after that.

Absence Seizure: In this seizure, loss of consciousness is too brief for a person to change his position. A person may blink rapidly and stare blankly for few seconds. This usually begins in childhood and continues through adolescence and adulthood.

Status Epilepticus: It is a phase of prolonged seizure for about 20 minutes or more or an array of seizures without regaining of full consciousness. This can be life-threatening.

The different kinds of partial or focal seizures can cause different symptoms:

Simple Partial Seizure: In this type of seizure, the electrical discharges remain confined therefore the person experiences a sensation, feeling, movement or any other symptom, but without losing consciousness. The person stays awake and aware. Symptoms depend on the specific brain area and include:

  • Jerking movements on the body’s one part
  • Abnormal smells or colored environment
  • Fear or rage.

Complex Partial Seizure: This is the most common kind of complex partial seizure, where a person is not aware of his surroundings and is partially or fully unresponsive. It can be a blank stare, lip-smacking or a repetitive movement of hands. After the seizure, the person is confused and goes through total memory loss.

Both the seizures can become a generalized one supposing that the electrical activity transmits from the part the seizure occurred to the rest of the cerebral cortex. Seizures are followed by confusion, lethargy, and drowsiness. Additionally, warning symptoms like an aura can happen just before the complex partial seizure and a generalized seizure.

Diagnosis of First Time Seizure in Adults

The diagnosis of first time seizure in adults is based on the symptoms. The physical and neurological examination is normal. An adult experiencing first-time seizure is evaluated with blood-test and head scan to check the chemical imbalances. The doctor may call for computed tomography or MRI of the brain. Most patients undergo EEG that monitors as well as records the brain waves through a series of electrodes put on the scalp. The specific abnormalities in the brain wave patterns help the doctor to identify the type of seizure.

Treatment of First Time Seizure in Adults

When the cause of the first time seizure in adults is identified like overuse of alcohol or a chemical imbalance in blood, the seizure goes away with proper treatment. If the cause of first time seizure cannot be ascertained, the seizures continue to happen and antiepileptic medication is prescribed. Treating epilepsy is complicated, in case a single medication cannot control the seizures fully, a neurologist should be consulted.

Status epilepticus can be a life-threatening medical issue. If it is not treated properly, it can cause brain damage and failure of vital organs. Treatment includes the application of antiepileptic medications into the vein till the seizures are under control.

When the medication cannot control the seizures, surgery is recommended. The decision to undergo surgery is dependent on many factors like the seriousness and frequency of the seizure, the risk of brain damage and injury due to frequent seizures, and the overall health of the patient. Treatment is recommended for the patients who show abnormalities in the brain scan, EEG or in a neurological examination. The patients who do not show any abnormality can reduce the risk of seizures through proper treatment.

Prevention of First Time Seizure in Adults

Epilepsy or first time seizure in adults is caused due to head injury or by any disease that can affect the brain. The best possible way to prevent seizure is by avoiding head injury. Do the following to prevent it:

  • Wear seat belts during driving
  • Avoid situations where head injury can happen
  • Equip the car with airbags
  • Wear helmet while riding a motorcycle, skating or cycling
  • Use protective headgear for sports.

People suffering from seizures are advised not to ride a motor vehicle or any dangerous machinery till the seizures are under control.

Management of First Time Seizure in Adults

The first-time seizure patients must be examined by a doctor. People with epilepsy having a brief and a self-limited seizure, do not need to call a doctor or do not need to visit an emergency. However, the emergency care must be explored if the patient does not return to normalcy post-seizure period, or if the seizure remains for more than few minutes or if a person gets multiple seizures.

For a tonic-clonic seizure patient, help him to lie down and loosen the tight clothing. Place anything soft under his head. Do not force anything in the mouth. In case of complex partial seizure, talk calmly with the patient and give protection from self-injury.

Prognosis of First Time Seizure in Adults

The seizures whose causes are identified are stopped once treated for the medical condition. Many people, whose cause of the seizure is not known, eventually stop experiencing the seizure if it begins during his childhood. They are well-controlled with proper medication.


It is advisable that the adults who have the first time seizure should consult a doctor who is a specialist for managing epilepsies, so that early diagnosis of the disease is made and appropriate treatment or therapy is initiated. With proper medication, first time seizure can be cured.


  1. Mayo Clinic. (2022). Seizures: First Aid. https://www.mayoclinic.org/first-aid/first-aid-seizures/basics/art-20056693
  2. Epilepsy Foundation. (n.d.). Types of Seizures. https://www.epilepsy.com/learn/types-seizures
  3. WebMD. (2021). What Causes Seizures? https://www.webmd.com/epilepsy/understanding-seizures-causes
  4. MedlinePlus. (2020). Seizures. https://medlineplus.gov/seizures.html
  5. Epilepsy Foundation. (n.d.). First Aid for Seizures. https://www.epilepsy.com/learn/seizure-first-aid-and-safety/first-aid-seizures
  6. National Institute of Neurological Disorders and Stroke. (2021). Seizures and Epilepsy: Hope Through Research. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Seizures-and-Epilepsy-Hope-Through
  7. Epilepsy Society. (n.d.). Epilepsy and Seizures: The Facts. https://www.epilepsysociety.org.uk/about-epilepsy#.YVcTdRrMK3J
  8. Healthline. (2021). Status Epilepticus. https://www.healthline.com/health/seizure/status-epilepticus
  9. Mayo Clinic. (2022). Seizures: Treatment. https://www.mayoclinic.org/diseases-conditions/epilepsy/diagnosis-treatment/drc-20350098

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 28, 2023

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