The short-term mortality in a prospective study of a cohort of 804 patients, aged 2 months to 94 years, with a first seizure was determined at the University Hospitals of Bordeaux and Montpellier, France. At 1-year follow-up, 149 patients had died as compared to 16 expected deaths. None who died had idiopathic seizures. Mortality was increased in patients with remote symptomatic seizures, provoked seizures, and seizures due to progressive neurologic disease. Only 6% of deaths were seizure-related. The majority (64%) were caused by the underlying pathology, 20% an unrelated condition, and 9% unknown factors. 
COMMENT. Early mortality following a first epileptic seizure is rarely related to the seizure per se and is determined by the underlying etiology, especially those with underlying pathology and with seizures caused by progressive neurologic disease, or by unrelated conditions. Provoked seizures must be distinguished from unprovoked seizures, when determining risk factors for a poor prognosis in epilepsy.