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Are afebrile seizures associated with minor infections a single seizure category? A hospital‐based prospective cohort study on outcomes of first afebrile seizure in early childhood
Author(s) -
Zhang Ting,
Ma Jiannan,
Gan Xiaoming,
Xiao g
Publication year - 2014
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.12651
Subject(s) - medicine , epilepsy , prospective cohort study , pediatrics , cohort , cohort study , convulsion , psychiatry
Summary Objective To explore if afebrile seizures associated with minor infections are a single category of seizure, or a set of different kinds of seizures. Methods We conducted this prospective cohort study on three kinds of first afebrile seizure: first afebrile seizure associated with gastrointestinal infection (AS‐GI), first afebrile seizure associated with nongastrointestinal infection (AS‐ nGI ), and first unprovoked seizure (US). The Kaplan‐Meier estimate risks of recurrent seizures were analyzed and compared pairwise. The characteristics of recurrent seizures were also compared pairwise. Results The Kaplan‐Meier estimate risks of recurrent seizure at 2 years of the AS ‐ GI , AS ‐n GI, and US groups were 6.9%, 23.7%, and 37.8%, respectively. The pairwise differences were significant between the AS ‐ GI and US groups (p < 0.001) and between the AS ‐ GI and AS ‐n GI groups (p = 0.001), but not significant between the US and AS ‐n GI groups (p = 0.066). Among unprovoked subsequent seizures in patients with recurrence, the pairwise differences were significant between the AS ‐ GI and US groups (p < 0.001) and between the AS ‐ GI and AS ‐n GI groups (p = 0.005), but not significant between the US and AS ‐n GI groups (p = 0.417). Significance Afebrile seizures associated with minor infections are indeed of two distinguishable kinds: AS ‐ GI , if free of risk factors such as a family history of epilepsy, had a better prognosis and should be categorized as an acute symptomatic seizure, whereas patients with first AS ‐ nGI , like patients with first US , may have recurrent unprovoked seizures, which suggests this category's essential difference from AS ‐ GI . A PowerPoint slide summarizing this article is available for download in the Supporting Information section here .