PURPOSE
To determine the frequency of presentation, etiological risk factors, and prognosis of acute symptomatic seizures among adult medical admission in a university hospital in Central Java Indonesia. 

METHOD
It was a one-year prospective descriptive study of adults patients admission with acute symptomatic seizures as the first presenting event in Dr. Moewardi Surakarta hospital within April 2016 – April 2017. Data obtained from following the progress of patient within admitting.

RESULTS
There were 268 cases of seizures that hospitalized during the periode under review, acute symptomatic seizure were found 77 cases (28.7%) . There were 38 (49.4%) males and 39 (50.6%) females aged between 18 years and 79 years, the highest is in the age group 41-60 years (40.23%). The etiological risk factors  were stroke in 36.3% (n=28) of cases, metabolic in 28.6% (n=22),  infection in 28.6% (n=22), and others in 6.5% (n=5). Infective causes were the prominent cause among those fourty and below years while stroke and metabolic cause were more in those aged above fourty. The seizure type was classified based on ILAE 1981 classification,  62.3% (n=48) were generalized seizures, 18.2% (n=14)  were partial seizures evolving to generalized seizures, 13 % (n=10) were complex partial seizures, and 6.5% (n=5) were simple partial seizures. The 30 days mortality rate among the patients was 25.9% (n=20). Among the 30 day survivors (74%, n=57), 25 patients (32%) reported their progress report, 23 patient didn’t experience subsequent unprovoked seizure and 2 patients developed epilepsy.

CONCLUSION
Characteristics of acute symptomatic seizure is not influenced by gender, most often found in middle adulthood, most patients have general tonic clonic type of seizure, the most common etiology is stroke. The 30 days mortality rate is 25.9%, among the 30 day survivors, individuals with first acute symptomatic seizure less likely to experience a subsequent unprovoked seizure.