Risk of Seizure Recurrence Following a First Unprovoked Seizure in Childhood
نویسندگان
1 Department of Pediatric Neurology
2 Gastroenterohepatology Research Center, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran/Lorstan University ofMedical Science, Khoramabad, Iran
3 Department of Pediatric Neurology
4 Department of Pediatric Neurology
doi
چکیده
Background: There is still a question whether first seizure leads to epilepsy. Several risk factors have beenreported in this relation. This study was undertaken to determine the risk of recurrence after a first unprovokedseizure in children.Methods: In a prospective study between December 2003 and December 2005, 156 children who presentedwith a first unprovoked seizure were enrolled and followed for at least 18 months. Potential predictors of recurrencewere compared, using the Cox Proportional Hazard model in a univariable and multivariate analysis. Survivalanalysis was performed, using the Kaplan-Meire curves.Results: Seventy two children (46.2%) experienced subsequent seizures. The cumulative risk of seizurerecurrence was 28.8%, 41.7% and 46.2% at 6, 12, and 24 months following the first seizure, respectively. Themedian time for repeated seizure was 4 months while 62.5% of the recurrence occurred within 6 months,88.9% within 1 year and 100% till the end of the second year. On multiple analysis, risk factors for resumptionof seizure consisted of abnormal electroencephalography (EEG), seizure during sleep, abnormal brain imagingand history of perinatal problems. On univariable analysis, abnormal EEG, abnormal imaging (remoteetiology of seizure), history of neonatal problems, previous febrile seizure, and family history of afebrile seizureincreased the risk of recurrence.Conclusion: The study revealed that the risk of seizure recurrence in our patients was relatively high. Thosewho had abnormal electroencephalography, past history of prenatal problems, remote etiology for seizure, abnormalbrain imaging, and seizure during sleep were at greater risk for recurrence of seizure.