nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2009-36nnp-22Research ArticleCLINICAL GUIDELINESКЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИORGANIZATION OF HEALTH CARE TO PATIENTS WITH NEW-ONSET CONVULSIVE SEIZUREОрганизация медицинской помощи пациентам с впервые развившимся судорожным припадкомНаумоваГ. И.NaumovaG. I.naumova@tut.byЦентр пароксизмальных состояний, Витебский областной диагностический центрБеларусьCenter of Paroxysmal States, Vitebsk Regional Diagnosis CenterBelarus20091406200912NO2 (2009)3741Copyright © Naumova G.I., 20092009Наумова Г.И.Naumova G.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/22

The first episode comprises one or several fits that first develop in a patient and may recur within 24 hours with a complete consciousness recovery between the fits. In addition to clinical characteristics, general somatic and neurological examinations, biochemical blood study, and brain electroencephalography and computed tomography or magnetic resonance imaging are recommended to define the prognosis of the first epileptic seizure and to elaborate therapeutic tactics. If the first acute symptomatic seizure (metabolic encephalopathy, acute central nervous system injury in patients with eliminable seizure-based condition) occurs, the disease that is a cause of the seizure should be treated. Symptomatic therapy for the first unprovoked seizure is unreasonable if only the seizure is not epileptic.

Первый припадок - это один или несколько припадков, которые развились у пациента впервые и могут повторяться в течение 24 ч с полным восстановлением сознания между ними. Для определения прогноза первого эпилептического припадка и выработки терапевтической тактики, кроме клинических характеристик, необходимы общее соматическое и неврологическое обследование, биохимическое исследование крови, электроэнцефалография и компьютерная томография или магнитно-резонансная томография головного мозга. При наличии первого острого симптоматического припадка (метаболическая энцефалопатия, острая травма ЦНС у пациентов с устранимым лежащим в основе припадка состоянием) назначается лечение заболевания, явившегося причиной припадка. Симптоматическая терапия первого неспровоцированного припадка неправомерна, если только припадок не является эпилептическим статусом.

первый припадокнеспровоцированный припадокэпилепсияриск рецидиваfirst seizureunprovoked seizureepilepsyrecurrence riskReferences<div><p>Hirtz D., Berg A., Bettis D. et al. Practice parameter: Treatment of the child with a first unprovoked seizure: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child neurology Society Neurology 2003; 60:166-75.</p><p>Beghi E. The management of a first seizure - Still a major debate. Epilepsia 2008; 49(Suppl.</p><p>Perrig S., Jallon P. Is the first seizure truly epileptic? Epilepsia 2008; 49(Suppl. 1):2-7.</p><p>Hauser W. Allen, Beghi E. First seizure definitions and worldwide incidence and mortality. Epilepsia 2008; 49(Suppl. 1):8-12.</p><p>Anne T. Berg. Risk of recurrence after a first unprovoked seizure. Epilepsia 2008; 49(Suppl. 1):13-8.</p><p>Pohlmann-Eden B., Newton M. First seizure: EEG and neuroimaging following an epileptic seizure. Epilepsia 2008; 49(Suppl. 1)19-25.</p><p>Beghi E., Giovanni De Maria, Gobbi G. et al. Diagnosis and treatment of the First Epileptic Seizure: Guidelines of the Italian League Against epilepsy. Epilepsia 2006; 47(Suppl. 5):2-8.</p><p>Hirtz D., Ashwal S., Berg A. et al. Practice parameter: Evaluating a first nonfebrile seizure in children: Report of the Quality Standards Subcommittee of the American Academy of Neurology, the Child Neurology Society, and the American Epilepsy Society. Neurology 2000; 55:616-23.</p><p>David W. Chadwick. The treatment of the first seizure: the benefits. Epilepsia 2008; 49(Suppl. 1):26-8.</p><p>Perucca E. The treatment of the first seizure: The risks. Epilepsia 2008; 49(Suppl. 1):29-34.</p><p>Beghi E. General conclusions and recommendations. Epilepsia 2008; 49(Suppl. 1):58-61.</p><p>Dominic C. Heaney, Gail S. Bell, Josemir W. Sander. The socioeconomic, cultural and emotional implications of starting or withholding treatment in a patient with a first seizure. Epilepsia 2008; 49(Suppl. 1):35-9.</p><p>Linda J. Stephen, Martin J. Brodie. Special problems: Adults and elderly. Epilepsy 2008; 49(Suppl. 1):45-9.</p></div><br /><div><p>Hirtz D., Berg A., Bettis D. et al. Practice parameter: Treatment of the child with a first unprovoked seizure: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child neurology Society Neurology 2003; 60:166-75.</p><p>Beghi E. The management of a first seizure - Still a major debate. Epilepsia 2008; 49(Suppl.</p><p>Perrig S., Jallon P. Is the first seizure truly epileptic? Epilepsia 2008; 49(Suppl. 1):2-7.</p><p>Hauser W. Allen, Beghi E. First seizure definitions and worldwide incidence and mortality. Epilepsia 2008; 49(Suppl. 1):8-12.</p><p>Anne T. Berg. Risk of recurrence after a first unprovoked seizure. Epilepsia 2008; 49(Suppl. 1):13-8.</p><p>Pohlmann-Eden B., Newton M. First seizure: EEG and neuroimaging following an epileptic seizure. Epilepsia 2008; 49(Suppl. 1)19-25.</p><p>Beghi E., Giovanni De Maria, Gobbi G. et al. Diagnosis and treatment of the First Epileptic Seizure: Guidelines of the Italian League Against epilepsy. Epilepsia 2006; 47(Suppl. 5):2-8.</p><p>Hirtz D., Ashwal S., Berg A. et al. Practice parameter: Evaluating a first nonfebrile seizure in children: Report of the Quality Standards Subcommittee of the American Academy of Neurology, the Child Neurology Society, and the American Epilepsy Society. Neurology 2000; 55:616-23.</p><p>David W. Chadwick. The treatment of the first seizure: the benefits. Epilepsia 2008; 49(Suppl. 1):26-8.</p><p>Perucca E. The treatment of the first seizure: The risks. Epilepsia 2008; 49(Suppl. 1):29-34.</p><p>Beghi E. General conclusions and recommendations. Epilepsia 2008; 49(Suppl. 1):58-61.</p><p>Dominic C. Heaney, Gail S. Bell, Josemir W. Sander. The socioeconomic, cultural and emotional implications of starting or withholding treatment in a patient with a first seizure. Epilepsia 2008; 49(Suppl. 1):35-9.</p><p>Linda J. Stephen, Martin J. Brodie. Special problems: Adults and elderly. Epilepsy 2008; 49(Suppl. 1):45-9.</p></div><br />

The authors declare that there are no conflicts of interest present.