Abstract
A 34-year-old man experienced a single unprovoked generalized tonic-clonic seizure in the earlier morning hours while asleep. His spouse was awakened during the respiratory alteration and the repetitive movements. The patient was in excellent health without a prior history of seizures or remote symptomatic neurologic disease. There was a history of migraine headaches and mild closed head trauma as a child. He was receiving no prescription drugs. The family history was negative for epilepsy. Upon evaluation in the emergency department, a CT of the head was normal. The patient was described as being "postictal" on examination. An EEG study several hours after the seizure showed bitemporal, nonspecific slowing without definite epileptiform activity. An MRI head was performed the following day and was unremarkable. The patient was referred by the emergency room physician for an outpatient neurologic consultation.