After a first seizure, a high recurrence risk is predicted by a prior brain insult such as stroke or trauma, an EEG with epileptiform abnormalities, a significant imaging abnormality, or a nocturnal seizure. A head injury 6 months ago is a prior brain insult (remote symptomatic seizure).

• Alcohol causes provoked seizures (withdrawal), which carry a low recurrence risk unless the trigger recurs.
• Family history of stroke and psychiatric history are not listed risk factors.