Diagnostic and Therapeutic Management of a First Unprovoked Seizure in Children and Adolescents With a Focus on the Revised Diagnostic Criteria for Epilepsy

Sansevere, Arnold J.; Avalone, Jennifer; Strauss, Lauren; Patel, Archana; Pinto, Anna; Ramachandran, Maya; Fernández, Iván Sánchez; Bergin, Ann M.; Kimia, Amir A.; Pearl, Phillip L.; Loddenkemper, Tobias

doi:10.1177/0883073817706028

Cited by 10 publications

(5 citation statements)

References 70 publications

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“…Frequent neurological exams should be performed to monitor for any focal deficits. In some cases, empiric anticonvulsant therapy may be warranted for patients with a high risk (>60%) of a second seizure due to underlying neurological conditions [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Late-Onset Seizure Disorder in Adult Cerebral Palsy Associated With COVID-19 Infection

McCauley¹,

Li²,

Kobrin³

2023

Cureus

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COVID-19 can affect many organ systems, including the CNS, with symptoms of altered mental status and seizures. We present a case of a 30-year-old man with cerebral palsy who developed seizures after a COVID-19 infection. Admission labs were remarkable for hypernatremia, and elevated creatine kinase, and troponin levels as well as creatinine above baseline. MRI was performed demonstrating a small, evolving acute/subacute abnormality in the midline splenium of the corpus callosum. An EEG showed moderate to severe abnormalities with low-voltage delta waves. The patient was treated with medication and advised to follow up with a neurologist. One month later, no residual CT abnormality corresponding to the previously reported lesion in the midline splenium of the corpus callosum was observed. Although epilepsy is a common finding in patients with cerebral palsy, the complete lack of seizure activity throughout this patient's early life, coupled with previously unremarkable brain imaging, further supports our claim that his recent onset of seizures was directly related to COVID-19. This case highlights the possibility of new seizures in patients with pre-existing neurological conditions after COVID-19 infection and emphasizes the need for more research.

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Section: Discussionmentioning

confidence: 99%

Late-Onset Seizure Disorder in Adult Cerebral Palsy Associated With COVID-19 Infection

McCauley¹,

Li²,

Kobrin³

2023

Cureus

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“…En una primera crisis no sintomática aguda, la actitud expectante sin iniciar tratamiento con fármacos anticrisis epilépticas estaría indicada como primera opción, salvo riesgo alto de recurrencia [ 11 ]. Los principales criterios descritos para iniciar tratamiento antiepiléptico desde la primera crisis son: alteraciones en el EEG, alteraciones en la neuroimagen y presentar patología de base [ 12 ]; mientras que los pacientes con una única crisis, EEG normal y sin patología previa tienen un riesgo bajo de recurrencia y en ellos no se ha visto disminución de este riesgo pese a iniciar tratamiento con fármacos anticrisis epilépticas [ 13 ].…”

Section: Discussionunclassified

Wait and see en epilepsia pediátrica. Nuestra experiencia

et al. 2023

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Introducción. El tratamiento farmacológico de la epilepsia no es curativo; pretende, en lo posible, evitar crisis en niños que probablemente van a seguir teniéndolas. Pacientes y métodos. El objeto es analizar nuestra experiencia en niños con epilepsia y con primera crisis no sintomática aguda no tratados con antiepilépticos. Se analizó a pacientes atendidos en una consulta de neuropediatría, desde 2017 hasta 2021, que habían sufrido una o más crisis no sintomáticas agudas y a los que no se les había tratado farmacológicamente. Resultados. Sesenta y cinco pacientes cumplieron los criterios de selección. Veinticuatro habían tenido una única crisis, con un tiempo medio de duración de 12 minutos (1-60). En un 66,7% fue nocturna. Un 41,7% presentó electroencefalograma patológico, y un 21%, hallazgos patológicos en la neuroimagen. El tiempo medio de control fue de 2,7 años (0,003-13,6 años). Cuarenta y uno presentaron más de una crisis, con una duración media de nueve minutos (1-60). Cinco pacientes presentaron más de 20 crisis, y el resto, entre dos y 17. Veinticuatro (58,5%) presentaron únicamente crisis nocturnas. Se realizó un electroencefalograma en todos: grafoelementos epileptiformes en el 63,4%; y neuroimagen en todos: patológica en el 4,9%. El tiempo medio de control fue de 3,8 años (0,01-9,1 años). Conclusiones. La frecuencia de las crisis, la patología de base o los resultados de las pruebas complementarias no deberían ser las únicas variables que habría que considerar para iniciar el tratamiento farmacológico antiepiléptico en los niños. Debería prevalecer, por encima de aquéllos, el potencial perjuicio sobre la calidad de vida y el neurodesarrollo, las funciones atencionales y el comportamiento del niño, y siempre consensuar esta decisión con los padres.

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“…Meanwhile, unprovoked seizures occur without an accurate trigger. 3,7 Unprovoked seizures can refer to single or recurring seizures (epilepsy). 7 Seizures are generally dominated by male patients.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of first unprovoked seizures in children aged 1 to 14 years ranges from 30 to 50 per 100,000. 3 An electroencephalogram (EEG) is a recording of brain activity used to investigate a first unprovoked seizure. 4 Epileptiform abnormalities on the EEG provide additional clinical information about seizures that may aid in the diagnosis and classification of seizures.…”

Section: Introductionmentioning

confidence: 99%

Electroencephalogram in Children who Experienced First Unprovoked Seizure

Vanadia

Gunawan

Abdurachman

et al. 2022

AKSONA : Aksona: Journal of Neurology and Neuroscience

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Highlight: Epiletiform abnormalities on the EEG provide additional clinical infromation about seizures The majority of patients who have a first unprovoked seizure have an abnormal EEG (Abnormal II). Using EEG as a supporting diagnostic tool in patients experiencing their first unprovoked seizures may provide more information to improve treatment ABSTRACT Introduction: The first unprovoked seizure is defined as a series of seizures that occur within 24 hours and are followed by recovery of consciousness with unknown triggering causes such as head trauma, central nervous system infections, tumors, or hypoglycemia. The first unprovoked seizure is a thing that cannot be underestimated. According to a previous study, less than half of those who experience their first unprovoked seizure will have another. An electroencephalogram (EEG) is one of the supporting examinations for the first unprovoked seizure. Objective: This study aims to determine the EEG as the first unprovoked seizure supporting examination. Methods: This is a retrospective, descriptive, observational study with sampling from the patient's medical record at Dr. Soetomo General Hospital Surabaya from January 2017 to December 2018 based on predetermined inclusion and exclusion criteria. Results: The EEG results in children who experienced their first unprovoked seizure were more abnormal (52.9%) than normal (47.1%), with an abnormal EEG breakdown of abnormal II (17.6%) and abnormal III (35.3%). There were no patients in this study who had EEG abnormal I. All patients with EEG abnormal II (17.6%) had an intermittent slow EEG waveform, while all patients with EEG abnormal III (35.3%) had a sharp waveform. The most common location of EEG wave abnormalities was temporal (55.6%). Conclusion: In the first unprovoked seizure, an EEG examination can assist clinicians as a seizure diagnostic assistant tool. It is hoped that the results of the EEG can provide better management of the first unprovoked seizure.

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Diagnostic and Therapeutic Management of a First Unprovoked Seizure in Children and Adolescents With a Focus on the Revised Diagnostic Criteria for Epilepsy

Cited by 10 publications

References 70 publications

Late-Onset Seizure Disorder in Adult Cerebral Palsy Associated With COVID-19 Infection

Late-Onset Seizure Disorder in Adult Cerebral Palsy Associated With COVID-19 Infection

Wait and see en epilepsia pediátrica. Nuestra experiencia

Electroencephalogram in Children who Experienced First Unprovoked Seizure

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