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Risk factors for seizure recurrence in children after first unprovoked seizure
Author(s) -
Mizorogi Sonoko,
Kanemura Hideaki,
Sano Fumikazu,
Sugita Kanji,
Aihara Masao
Publication year - 2015
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12600
Subject(s) - medicine , pediatrics , electroencephalography , hazard ratio , incidence (geometry) , partial seizures , epilepsy , prospective cohort study , confidence interval , psychiatry , physics , optics
Background The question of whether to treat a patient after a first unprovoked seizure is controversial. This prospective study assessed the time to recurrence and risk factors for seizure recurrence after a first unprovoked seizure in children. Methods Participants were recruited between 1 J uly 1997, and 30 J une 2009. Eligible candidates were children between 1 month and 15 years old who presented with their first unprovoked afebrile seizure. After enrollment, recurrence of seizures was investigated. All participants were followed for at least 2 years. Log‐rank test was used for bivariate analysis to check associations, and hazard ratios were used to analyze variables and clinical outcome (recurrence) during follow‐up. Results Of 73 subjects, 42 (57.5%) experienced recurrence. The overall product‐limit estimate of recurrence was 61.9% at 6 months, 85.7% at 1 year, and 95.2% at 2 years after seizure onset, respectively. Incidence of recurrence with partial and generalized seizures was 69.0% and 31.0%, respectively. Children with partial seizures had recurrence significantly more often than those with generalized seizures ( P < 0.001). Recurrent seizures occurred after normal findings on electroencephalogram ( EEG ) in 21.4%, after generalized spike‐and‐wave complexes in 16.7%, and after focal epileptic discharge in 61.9%. Children with focal epileptic discharge had recurrence significantly more often than children with normal EEG findings ( P < 0.001). Conclusion The time to seizure recurrence after first unprovoked seizure may be within 1 year, and particularly within 6 months; and partial seizure and abnormal EEG with focal epileptic discharge may be risk factors for seizure recurrence.