Department of Neurology

First seizure in a teen

Q: My 17 year old son suffered a seizure for the first time last night. He was with friends when it occured. He had complained of not feeling well and of having a headache immediately before. His friends say he had also complained of not feeling well about 3 hours before the seizure. He remembers feeling ill, then in a dreamlike state. He then lost conciousness and woke up in the ambulance. He felt fine at the hospital. The CT scan and blood tests showed nothing abnormal. His urine showed the presence of marijuana. Although he denies it, he may have been drinking beer.

He suffered a concussion and was knocked unconcious in football practice almost two years ago, but seemed to fully recover.

He's very healthy and athletic but has been taking a dietary supplement called phosphagen. The lablel describes is at a "creatine" supplement. He says he hasn't taken any for about a week.

We would appreciate any ideas on a possible explanation for the seizure. Would this incident automatically prevent him from participating in sports ?

Thank you.

A: First, he should be evaluated carefully by a neurologist to exclude brain problems that may have caused the seizure. In many persons, no specific brain abnormalities can be found. Whether to treat a single seizure with long-term drug therapy is controversial, but there may be other indicators of epilepsy in his evaluation.

When he may return to sports depends on what seems to be the cause of his seizure. In any event, it would be most prudent to wait until he has gone seizure free for a period of time (most neurologists pick 6 mos-1 yr) before he engages in any activity where loss of consciousness would place him at risk.

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