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Whenever someone has a seizure for the first time, he or she should be taken to an emergency room, as there may be a serious underlying medical condition which needs to be treated. First-aid measures should be performed as appropriate, including protecting the person from injury during the seizure, preventing him or her from inhaling vomit or mucus into the lungs, keeping the airway clear, and assistance with breathing.
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Treatment of the causes may stop the seizures. This may include medication, surgical repair of tumors or brain lesions, and other treatments.
An isolated seizure with an obvious avoidable trigger, such as fever or toxic reactions, is treated by removing or treating the precipitating factor.
An isolated seizure may not require treatment. Findings on MRI or EEG may determine how likely recurrent seizures are and may help determine the need for ongoing treatment, such as anticonvulsants (anti-seizure medications). The response to these drugs varies, and medication and dosage may have to be adjusted repeatedly.
Multiple, repeated seizures are usually treated with anti-seizure drugs such as phenytoin or carbamazepine for preventive, long-term use. Follow-up includes review of the need for drugs and monitoring for side effects. Drugs may need to be continued indefinitely.
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