Anecdotal observations by emergency physicians at Straub Clinic and Hospital suggest that first-time seizures are common in Japanese tourists visiting Hawaii. Because such patients seemed to present in the evening of their day of arrival, some physicians have attributed these seizures to sleep deprivation based primarily upon clinical impressions. However, there has been no previous review of these cases to confirm the impression that these seizures have a relatively benign cause. This retrospective study aims to identify the role of sleep deprivation as a potential factor in seizures within this population.