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Among the 24 invited controversies published in the Archives, none has generated more interest or passion than the management of a first seizure.
Part of the explanation for such vehemence may be that the controversy combines the difficulty of making a diagnosis with the uncertainty of prognosis and with differing physicians' philosophies as to how to handle both. The three viewpoints advanced in this revisited controversy elaborate on points made more directly and less diplomatically to the Editor of CONTROVERSIES IN NEUROLOGY by others.
Although the aim of CONTROVERSIES IN NEUROLOGY is to focus and simplify important issues, it would be unwise to force consensus where the evidence does not allow it, so that the above viewpoints are offered without editorial comment. Einstein is alleged to have admonished that we should try to make things as simple as possible, but no simpler.
Hachinski V. First Seizure Management—Reconsidered. Arch Neurol. 1987;44(11):1191. doi:10.1001/archneur.1987.00520230071020