Evaluation of the first seizure patient: Key points in the history and physical examination.

•The first seizure evaluation rests primarily on the clinical history.•An accurate description of the spell is necessary to confirm the diagnosis.•Identifying prior unrecognized seizures may change the diagnosis to epilepsy.•The interview aims to find specific acute or remote symptomatic seizure etiologies.•The clinical findings influence further investigations, prognostication, and therapy.