EM Cases · Seizures and first fit
Counselling after a first seizure — the communication station
An ACEM Fellowship OSCE communication station. Tests the counselling of a young adult after a first unprovoked seizure: the diagnosis, the recurrence risk, the antiepileptic drug decision, the driving restriction and the legal duty to notify, the lifestyle safety advice, and the follow-up pathway. Maps to the OSCE communication domain. ACEM-primary, globally tagged.
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Station brief
Format. Communication station, 11 minutes total — 3 minutes reading, 8 minutes active counselling. You are the Emergency Medicine consultant. The actor plays the patient, Daniel, a 22-year-old university student.
Candidate instructions. Daniel has been assessed and investigated. His bedside glucose, electrolytes, ECG and CT brain are normal, and he is fully recovered and back to baseline. This was a first seizure. Counsel him on his discharge — the diagnosis, the chance of another seizure, the medication, the driving, the lifestyle advice, and the follow-up. The examiner assesses your communication and the accuracy of your advice.[1]
References2ShowHide
- [1]Krumholz A, Wiebe S, Gronseth GS, et al. Evidence-based guideline: Management of an unprovoked first seizure in adults: Report of the Guideline Development Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology, 2015.PMID 26503589
- [2]Marson A, Jacoby A, Johnson A, et al. Immediate versus deferred antiepileptic drug treatment for early epilepsy and single seizures: a randomised controlled trial (MESS). Lancet, 2005.PMID 15950714