This review analyses the diagnostic, prognostic and therapeutic aspects of a first epileptic crisis occurring in adult patients. Although it is generally accepted that a cranial CT scan is indicated after the first crisis in order to rule out a structural cerebral lesion after the first crisis, the need for cerebral MR studies in such cases is debatable. The decision to begin anticonvulsant treatment is very controversial, mainly because of the difficulty in assessing the risk of recurrence in any given person. In each case this decision should be reached after bearing in mind the factors indicating risk of recurrence, the patient's personal condition, their work and their own opinion.
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