Journal of Patient Safety & Quality Improvement

Journal of Patient Safety & Quality Improvement

Examination of electroencephalography (EEG) parameters within 24 hours after the first seizure

Document Type : Original Article

Authors
Abolfazl Atalu 1
Ghasem Fattahzadeh-Ardalani 1
Danial Akbarpouran badr 2
1 Department of Neurology, School of medicine, Ardabil university of medical science, Ardabil, Iran
2 School of medicine, Ardabil university of medical science, Ardabil, Iran.
10.22038/psj.2026.95000.1527
Abstract
Background:
Abnormal EEG is a predictor of seizure relapse. Obtaining data related to the diagnosis and outcome of the first seizure is necessary for improving care for these patients. We aimed to examination of electroencephalography parameters within 24 hours after the first seizure attack.
 
methods:
This cross-sectional study was done on 91 patients with the first seizure attack who referred to Alavi Hospital in Ardabil in 2023 were included in the study. The necessary information including age, sex, etiology of seizure, type of seizure and routine and stimulation modalities with abnormal waves were collected.
 
Results:
Of all patients, 47 (51.6%) were men and 44 (48.4%) were women with an average age of 38 years. According to the type of seizure in patients, in 69 cases (75.8%), it was generalized type. Electroencephalography (EEG) findings were reported as normal in 50 cases (54.9%). In patients with abnormal EEG, in 34 patients (82.9%) these waves were found in routine modality, 4 cases (9.8%) in Hyperventilation (HV) modality and other 3 cases (7.3%) in photic stimulation (Ph.S) modality. There was a significant relationship between EEG findings and the etiology as well as the type of seizure.
 
Conclusions:
The results of this study showed that, in idiopathic cases, the most common EEG finding was normal, whereas in cases of hypoglycemia, the most common finding was non-epileptic abnormal waves. Furthermore, in focal seizures, the most common EEG finding was also non-epileptic abnormal waves.
Keywords
Electroencephalography
Seizures
Modality
Etiology
Subjects
  1. Palka D, Yogarajah M, Cock HR, Mula M. Diagnoses and referral pattern at a first seizure clinic in London. Journal of Epileptology. 2017;25(1-2):31-6.
  2. Nowacki TA, Jirsch JD. Evaluation of the first seizure patient: Key points in the history and physical examination. Seizure. 2017;49:54-63.
  3. Rosenow F, Weber J, Deutsche Gesellschaft für Neurologie (DGN), Österreichische Gesellschaft für Neurologie (ÖGN). S2k guidelines: status epilepticus in adulthood : Guidelines of the German Society for Neurology. Nervenarzt. 2021;92(10):1002-1030. German. doi: 10.1007/s00115-020-01036-2.
  4. İşgüder R, Dilsiz P, Tosun A, et al. Characteristics and clinical value of early electroencephalography (EEG) after a first unprovoked seizure in children. Neurophysiol Clin. 2023;53(1):102848. doi: 10.1016/j.neucli.2023.102848.
  5. Shayeste H, Asl BM. Heterogeneous recurrence analysis of imaged-EEG for spatio-temporal epileptic seizure detection. IEEE J Biomed Health Inform. 2023;27(1):351-362. doi: 10.1109/JBHI.2022.3208598.
  6. Song Z, Deng B, Zhu Y, et al. Probing epileptic disorders with lightweight neural network and EEG's intrinsic geometry. Nonlinear Dyn. 2023;111:5817-5832.
  7. Lopez MR, LaFrance WC Jr. Treatment of psychogenic nonepileptic seizures. Curr Neurol Neurosci Rep. 2022;22(8):467-474.
  8. Asadi-Pooya AA, Farazdaghi M. Generalized spike–waves in idiopathic generalized epilepsies: Does their frequency matter? Brain Behav. 2024;14(10):e70023. doi: 10.1002/brb3.70023.
  9. Corso C, De Stefano P, Urbach S, et al. Seizure in the emergency department: Risk and predictors of early recurrency during observation. Epilepsy Res. 2025;214:107572. doi: 10.1016/j.eplepsyres.2025.107572.
  10. Li Y, Zhang W, Chen J, et al. The predicative value of early quantitative electroencephalograph in epilepsy after severe traumatic brain injury in children. Front Pediatr. 2024;12:1370692. doi: 10.3389/fped.2024.1370692.
  11. Oyama M, Hoshino H, Hoshino S, et al. Early-phase EEG power spectrum analysis may differentiate acute encephalopathy with biphasic seizures and late reduced diffusion from prolonged febrile seizures. Epilepsy Res. 2025;210:107515. doi: 10.1016/j.eplepsyres.2025.107515.
  12. Lopes MA, Bhatia S, Brimble G, Zhang J, Hamandi K. A computational biomarker of idiopathic generalized epilepsy from resting state EEG. eNeuro. 2022;9(5):ENEURO.0409-21.2022.
  13. Tilahun BBS, Bautista JF. Psychogenic nonepileptic seizure: An empathetic, practical approach. Cleve Clin J Med. 2022;89(5):252-259. doi: 10.3949/ccjm.89a.21109.
  14. Beimer NJ, LaFrance WC Jr. Evaluation and treatment of psychogenic nonepileptic seizures. Neurol Clin. 2022;40(4):799-820.

 

 

 

 

 

Journal of Patient Safety & Quality Improvement
Volume 14, Issue 3
Summer 2026
Pages 147-153