Risk of recurrence after a first unprovoked seizure

  title={Risk of recurrence after a first unprovoked seizure},
  author={Anne T. Berg},
  • A. Berg
  • Published 1 January 2008
  • Medicine
  • Epilepsia
The risk of recurrence after a first unprovoked seizure has been examined in numerous observational studies and two large, high‐quality randomized trials. Overall, in untreated individuals, 40–50% can expect a recurrence within 2 years of the initial seizure. Treatment may reduce this risk by as much as half. Those at the greatest risk of recurrence have either an abnormal EEG or an identifiable neurological condition or symptoms consistent with one (“symptomatic”). Status epilepticus and a… 
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This work analyzed long‐term outcomes after the first‐ever seizure, and the influence of duration of seizure freedom on the likelihood of seizure recurrence, and their relevance to the new definition of epilepsy.
Risk of recurrence after a first unprovoked seizure in children.
Predictors of Recurrence after a First Unprovoked Seizure in Childhood: A Prospective Study
Assessment of the recurrence rate and associated risk factors for recurrences after a first unprovoked seizure in children within two years of first attack found identifying the high risk group of recurrence helps to initiate early antiepileptic drug and prevent further recurrence.
Management of the first seizure: an evidence based approach
The current evidence on this multifaceted clinical problem which would help formulate a rational management plan is discussed, including AED treatment after the first seizure.
New-Onset Seizure in Adults and Adolescents: A Review.
A careful patient history and physical examination, electroencephalography, and brain imaging are necessary to separate patients with acute symptomatic seizures, single unprovoked seizures, and nonepileptic events from those with new-onset epilepsy.
Evidence-based guideline: Management of an unprovoked first seizure in adults
Clinicians should advise that immediate treatment will not improve the long-term prognosis for seizure remission but will reduce seizure risk over the subsequent 2 years, and patients should be advised that risk of AED adverse events (AEs) may range from 7% to 31% and that these AEs are likely predominantly mild and reversible.
Diagnostic and Therapeutic Management of a First Unprovoked Seizure in Children and Adolescents With a Focus on the Revised Diagnostic Criteria for Epilepsy
This review summarizes the current literature on the diagnostic and therapeutic management of first unprovoked seizure in children and adolescents while taking into consideration the revised diagnostic criteria of epilepsy.
Risk factors for seizure recurrence in a pediatric observation unit.


Risk of Recurrence After an Initial Unprovoked Seizure
A cohort of 424 patients was followed to determine the patterns of risk for recurrence after an initial unprovoked seizure, and EEG abnormalities, abnormal neurologic examination findings, and initial partial seizures were identified as significant independent predictors of higher recurrence risks.
The risk of seizure recurrence after a first unprovoked afebrile seizure in childhood: an extended follow-up.
The majority of children with a first unprovoked seizure will not have recurrences, and children with cryptogenic first seizures and a normal EEG whose initial seizure occurs while awake have a particularly favorable prognosis, with a 5-year recurrence risk of only 21%.
Risk of recurrence after first unprovoked tonic-clonic seizure in adults
It is suggested that the majority of recurrences after a first unprovoked seizure were seen in the first year (in this series 89% of all recurrence), and there was no significant predictor of seizure recurrence, except the time of day at which the initial seizure occurred.
The first unprovoked, untreated seizure in childhood: a hospital based study of the accuracy of the diagnosis, rate of recurrence, and long term outcome after recurrence. Dutch study of epilepsy in childhood
The overall prognosis for a child presenting with a single seizure is excellent, even if treatment with antiepileptic drugs is not immediately instituted, as well as the recurrence rate within two years, the risk factors for recurrence, and the long term outcome two years after recurrence.
Predictors of multiple seizures in a cohort of children prospectively followed from the time of their first unprovoked seizure
Assessment of the risk of multiple recurrences after an initial seizure recurrence in childhood suggests that two seizures are a sufficient epidemiological criterion for the definition of epilepsy.
Initial EEGs showing generalized, unprovoked spikes and waves, generalized paroxysmal discharges precipitated by intermittent photic stimulation, or isolated slowing, were associated with risks of recurrence at two years of 40, 50 and 26 per cent, respectively.
First seizure definitions and worldwide incidence and mortality
The incidence of single unprovoked seizures predominate in men and in patients less than 12 months and older than 65 years, and the mortality of acute symptomatic seizures is lacking.