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Recurrence risk after a first remote symptomatic unprovoked seizure in childhood: a prospective study
Author(s) -
RAMOSLIZANA J,
AGUIRRERODRÍGUEZ J,
AGUILERALÓPEZ P,
CASSINELLOGARCÍA E
Publication year - 2009
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.2008.03124.x
Subject(s) - medicine , paresis , pediatrics , confidence interval , proportional hazards model , prospective cohort study , encephalopathy , epilepsy , hazard ratio , surgery , psychiatry
The aim of this study was to assess recurrence risk after a first remote symptomatic unprovoked seizure in childhood. All consecutive patients younger than 14 years with a first remote symptomatic unprovoked seizure who were seen at our hospital between 1994 and 2006 were included in the study and prospectively followed. Only two patients received antiepileptic treatment. Sixty‐three children were included, with 35 males and 28 females. Mean age at first seizure was 4 years (SD 3y 5mo). Kaplan–Meier estimate of recurrence risk was 59% (95% confidence interval [CI] 47–71), 76% (95% CI 65‐87), 85% (95% CI 76–94), and 87% (95% CI 78–96) at 6, 12, 18, and 24 months respectively. A total of 55 children out of 63 were affected by a static encephalopathy of pre‐ or perinatal origin. In this subgroup, recurrence risk at 12 and 24 months was 79% (95% CI 68–90) and 89% (95% CI 80–98). Univariable analysis using the Cox proportional hazards model showed that presence of global developmental delay/intellectual disability and Todd’s paresis were associated with a significant increase in recurrence risk. In multivariable analysis, only Todd’s paresis was significantly associated. Recurrence risk after a first remote symptomatic unprovoked seizure in childhood is much higher than what some previous studies suggests.