First seizure assessment

First Seizure Consultation with EEG Reporting A coordinated specialist pathway from assessment to interpretation

Dr Francesco Manfredonia offers a private first seizure consultation with specialist EEG reporting for appropriate adult patients, bringing neurological assessment and clinical neurophysiology together within one coordinated pathway.

The service is designed for people who have experienced a first suspected seizure, blackout, collapse or unexplained episodic event and require specialist neurological assessment.

Understanding the event

What happens after a first suspected seizure?

Experiencing a suspected first seizure can be frightening and can leave both the individual and their family with many unanswered questions. Importantly, not every blackout, collapse or unusual episode is caused by epilepsy.

A first seizure assessment therefore begins with the event itself. Details such as what happened beforehand, what was witnessed during the episode, how long it lasted and how quickly the person recovered afterwards can all provide important diagnostic information.

Dr Francesco Manfredonia combines experience in both clinical neurology and neurophysiology. This allows the initial neurological assessment and, where indicated, EEG findings to be considered together rather than as separate pieces of information.

The aim is to establish whether the episode is likely to have been a seizure, consider possible alternative explanations, identify whether further investigation is required and provide clear advice about what happens next.

A joined-up service

A coordinated first seizure and EEG pathway

Rather than treating consultation, testing and interpretation as disconnected stages, the service is designed to bring the relevant elements together within one specialist neurological pathway.

Clinical assessment

First seizure consultation

A detailed neurological consultation explores the event, preceding symptoms, witness observations, recovery, medical history and any previous episodes.

Investigation

EEG where indicated

Where an EEG is clinically appropriate, electrical activity from the brain can be recorded to provide additional information relevant to the neurological assessment.

Specialist interpretation

EEG reporting

Dr Manfredonia interprets the EEG in the context of the patient's history and clinical presentation rather than considering the test result in isolation.

Next steps

Clear clinical plan

Findings are brought together to help determine whether further investigation, treatment, follow-up or onward referral is required.

Not every patient experiencing a first suspected seizure will require the same tests. Investigations are selected according to the individual clinical circumstances and an EEG is arranged where it is considered clinically useful.

Specialist diagnosis

Not every unexplained episode is epilepsy

One of the most important parts of first seizure assessment is distinguishing an epileptic seizure from other events that can sometimes appear similar.

Seizures

Epileptic seizure

A seizure results from abnormal electrical activity within the brain. Its appearance depends on which areas of the brain are involved and not all seizures cause convulsions.

Loss of consciousness

Fainting and syncope

A faint can sometimes include movements that may be mistaken for a seizure. The circumstances before the collapse and pattern of recovery can be particularly informative.

Other events

Non-epileptic episodes

Other neurological, cardiac, sleep-related or functional events may sometimes resemble seizures, making careful clinical assessment important before reaching a diagnosis.

EEG assessment

What does an EEG show after a suspected seizure?

Electroencephalography, usually referred to as EEG, records electrical activity from the brain using small sensors positioned on the scalp.

An EEG can sometimes identify patterns that support a diagnosis of epilepsy or provide information that helps classify a seizure disorder. It may therefore form an important part of the investigation following a first suspected seizure.

However, EEG findings must always be interpreted alongside the patient's clinical history. A normal routine EEG does not automatically exclude epilepsy, and an abnormal EEG result should not be considered without the wider clinical context.

Your consultation

What happens during a first seizure assessment?

The description of an episode can be as important as the investigation results themselves. Dr Manfredonia will therefore explore what happened before, during and after the event in detail.

Where another person witnessed the episode, their description can be particularly valuable. Video recordings may also be helpful where they exist and can be safely shared.

Detailed description of the suspected seizure or blackout
Symptoms immediately before the event
Witness description of what happened
Duration of the episode and recovery afterwards
Previous unexplained episodes or neurological symptoms
Medical history, medications and relevant family history
Neurological examination where appropriate
Review of existing scans, blood tests or hospital records
Discussion of whether EEG or other investigations are indicated
Advice regarding treatment, follow-up and practical safety
Preparing for your appointment

Information that may help your assessment

You do not need to have all of this information available, but where possible it can help Dr Manfredonia build a clearer picture of what happened.

A witness account

If someone saw the episode, their description can be extremely useful. They may attend the consultation where appropriate or provide an account beforehand.

Any video recording

If an episode was safely recorded on a phone, the video may provide useful clinical information about what occurred.

Hospital information

Bring any discharge summaries, ambulance reports, scan results, blood test results or previous neurological correspondence that you already have.

Your medication list

A current list of prescription medicines, over-the-counter medicines and relevant supplements can help during assessment.

Details of previous events

Make a note of any earlier unexplained blackouts, unusual sensations, periods of altered awareness or similar episodes.

Questions you would like answered

It is completely reasonable to arrive with questions about diagnosis, investigations, medication, driving, work, exercise or recurrence risk.

Important safety information

When urgent medical attention is needed

A private first seizure consultation is an outpatient service and is not a substitute for urgent or emergency medical assessment.

Call 999 for a prolonged seizure or medical emergency

Urgent medical attention is required if a seizure lasts 5 minutes or more, another seizure begins without recovery between events, breathing is affected, there is serious injury or you are otherwise concerned that the situation is an emergency.

Driving after a suspected seizure

A suspected seizure can have implications for driving. Individual circumstances differ and appropriate advice will be discussed during specialist assessment. Patients should follow current UK driving regulations and medical guidance.

Specialist expertise

Consultant Neurologist and Neurophysiologist

Dr Francesco Manfredonia has worked as a Consultant Neurologist since 2007 and has particular clinical experience in epilepsy, seizure disorders and clinical neurophysiology.

Since 2017, he has led Neurology and Neurophysiology services at the Royal Wolverhampton NHS Trust, supporting the development of neurological and neurophysiological pathways and specialist patient care.

His combined neurological and neurophysiology experience is particularly relevant when investigating suspected seizures because the clinical presentation and EEG findings can be considered together.

Consultant practice Consultant Neurologist since 2007.
Epilepsy Extensive experience assessing seizures, epilepsy and episodic neurological events.
EEG Clinical neurophysiology expertise including EEG interpretation.
Clinical leadership Leadership across Neurology and Neurophysiology services since 2017.
Birmingham private service

First seizure assessment in Edgbaston

Private neurological consultations are available with Dr Francesco Manfredonia at Midland Health - Francis Road in Edgbaston, Birmingham.

The location provides access to Dr Manfredonia's private neurology and developing neurophysiology service, including the coordinated first seizure and EEG pathway where appropriate.

Clinic

Midland Health

Francis Road, Edgbaston, Birmingham B16 8SP.

Neurology

Specialist assessment

Consultant neurological assessment following a suspected first seizure, blackout or unexplained episodic event.

Neurophysiology

EEG reporting

EEG assessment and specialist interpretation where clinically indicated.

Next steps

Clear clinical guidance

Explanation of findings and recommendations regarding further investigation, treatment or follow-up.

Frequently asked questions

First seizure consultation and EEG

Common questions about private assessment following a first suspected seizure or unexplained episode.

Does one seizure mean I have epilepsy?

No. A single suspected seizure does not automatically mean that a person has epilepsy. Specialist assessment considers the nature of the event, possible triggers, medical history and investigation results before determining the most likely explanation.

Do I always need an EEG after a first seizure?

Not necessarily. Whether an EEG is helpful depends on the clinical circumstances. Dr Manfredonia will determine which investigations are appropriate following neurological assessment.

Can an EEG diagnose epilepsy?

EEG can provide evidence that supports a diagnosis of epilepsy, but epilepsy remains a clinical diagnosis and the EEG must be interpreted alongside the description of the event and wider medical history.

Can an EEG be normal if I have had a seizure?

Yes. A routine EEG can be normal between seizures even in someone who has epilepsy. A normal result therefore does not automatically exclude a seizure disorder.

What should I bring to my first seizure consultation?

Helpful information can include hospital or ambulance records, medication lists, previous test results, a witness account and any safe video recording of the event. Do not worry if all of these are not available.

Can someone who witnessed the seizure attend the consultation?

Yes, where appropriate. A witness can often provide useful detail about the appearance and duration of the episode and how the person recovered afterwards.

Where is the first seizure service available?

Private neurological assessment is available with Dr Francesco Manfredonia at Midland Health - Francis Road in Edgbaston, Birmingham. EEG can be incorporated into the pathway where clinically appropriate.

Can I arrange a private consultation without a GP referral?

Self-paying patients can often arrange a consultation directly. Patients using private medical insurance should check whether their insurer requires a referral or pre-authorisation.

Private first seizure assessment

Arrange a first seizure consultation

If you have experienced a first suspected seizure, blackout, collapse or unexplained episodic event, you can enquire about specialist neurological assessment with Dr Francesco Manfredonia and EEG reporting where clinically appropriate.