A number of studies have investigated the outlook for patients who present soon after a first-ever single, unprovoked epileptic seizure. Such seizures are usually of a bilateral tonic-clonic nature. It has been demonstrated that further attacks occur in 40 to 50% of individuals who are not subsequently treated with anticonvulsants, most of the recurrences occurring within 6 months of the initial seizure. The risk of recurrence is higher if the initial seizure is a partial one, if abnormal neurological findings are present, or if the EEG is abnormal. Two studies have now shown that the risk of seizure recurrence is more than halved if anticonvulsants are prescribed from the time of presentation after the initial seizure.Therefore, it appears that there is a case for commencing anticonvulsant therapy if a patient is seen in the first few months after a single unprovoked seizure which is of a partial type, or if abnormalities are present on neurological examination, or if the EEG shows paroxysmal activity. Anticonvulsants appropriate for the patient's seizure type should be used.