When should I consider starting antiepileptic medication in a patient who has had a first seizure?

Consider initiating antiepileptic medication after a first unprovoked seizure if any of the following apply: an examination identifies signs of neurological deficit, the electroencephalogram (EEG) shows unequivocal epileptic activity, the person or their family or carers consider the risk unacceptable after a discussion of the risk of further seizures, or brain imaging shows a structural abnormality ¹.