Prognosis of adults and children following a first unprovoked seizure

Neligan, Aidan; Adan, Guleed; Nevitt, Sarah J; Pullen, Angie; Sander, Josemir W.; Marson, Anthony G

doi:10.1002/14651858.cd013847

Cited by 5 publications

(5 citation statements)

References 22 publications

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“…Eighty‐two patients (45.5%) completed 6‐month follow‐up assessments, in which seizure recurrence was greater among those with ASyS (24%) than UPS (11.2%, p = 1.0) but the difference was not significant. These numbers are in accordance with previous published reports 9 and also with a recent of Cochrane's review 10 that reported 25% of seizures recurrence during a 6‐month follow‐up among adult patients with UPS. Longer follow‐up is necessary to determine the risk of recurrence, as recommended for the ILAE's epilepsy definition criteria.…”

Section: Discussionsupporting

confidence: 92%

“…8,9 The risk of recurrence for UPS is highest in the first 3-6 months. 10 In untreated individuals, 40%-50% with UPS experience recurrence within 2 years, but treatment can halve this risk. 9 Data on ASyS recurrence are lacking, 11 complicating prognosis and treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Immediate management is needed for ASyS due to life‐threatening underlying conditions and distinguishing ASyS from UPS influences decisions regarding antiseizure medication 8,9 . The risk of recurrence for UPS is highest in the first 3–6 months 10 . In untreated individuals, 40%–50% with UPS experience recurrence within 2 years, but treatment can halve this risk 9 .…”

Section: Introductionmentioning

confidence: 99%

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Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America

Carpio,

Salgado,

DiCapua

et al. 2024

Epilepsia Open

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There are limited data on first seizure (FS) among adults in low and middle‐income countries. We describe findings from a prospective cohort study involving 180 adults presenting with seizures in emergency departments in five Latin American countries. Overall, 102 participants (56.7%) had acute symptomatic seizures (ASyS) while 78 (43.3%) had unprovoked seizures (UPS). Among patients with ASyS, 55 (53.9%) had structural causes, with stroke (n = 24, 23.5%), tumor (n = 10, 9.8%), and trauma (n = 3, 3%) being the most frequent. Nineteen patients (18.6%) had infectious causes, including four (4%) with meningoencephalitis, three (3%) neurocysticercosis, and two (2%) bacterial meningoencephalitis. Twenty patients (19.6%) had metabolic/toxic evidence, including four (4%) with uremic encephalopathy, two (2%) hyponatremia, and three (3%) acute alcohol intoxication. Immune dysfunction was present in seven (7%) patients and neurodegenerative in two (2%). Among participants with UPS, 45 (57.7%) had unknown etiology, 24 (30.7%) had evidence of structural disorders (remote symptomatic), four (5%) were related to infectious etiology (>7 days before the seizure), and five (6.4%) had genetic causes. During the 3‐ and 6‐month follow‐up, 29.8% and 14% of patients with UPS, respectively, experienced seizure recurrence, while 23.9% and 24.5% of patients with ASyS had seizure recurrence. Longer follow‐up is necessary to assess seizure recurrence for patients with ASyS after the acute cause is resolved and to determine the 10‐year risk of recurrence, which is part of the definition of epilepsy.Plain Language SummaryWe monitored 180 adults who presented with their first seizure in emergency departments across five Latin American countries. Among these patients, 57% had acute symptomatic seizures, with structural causes such as stroke (23%), infection (17%), or tumor (10%) being more prevalent. Among the 43% with unprovoked seizures, 58% showed no identifiable acute cause, while 6.4% were due to genetics. Within 3 months after their initial seizure, 26.6% of individuals experienced a second seizure, with 11.9% continuing to have seizures in Months 3–6. Between Months 3 and 6, an additional 20% of patients encountered a second seizure. Research is needed to better understand the cause and prognosis of these patients to improve outcomes.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America

Carpio,

Salgado,

DiCapua

et al. 2024

Epilepsia Open

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“…To avoid unnecessary duplication of work, we will use the same search for both this review and the overall prognosis review (Neligan 2021). However, we anticipate several of the papers included in Neligan 2021 will not be eligible for this review.…”

Section: Librarymentioning

confidence: 99%

Prognostic factors predicting an unprovoked seizure recurrence in children and adults following a first unprovoked seizure

Adan

Neligan

Nevitt

et al. 2021

Cochrane Database of Systematic Reviews

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“…It's defined as a brain disorder marked by an enduring proclivity for epileptic seizures, as well as the neurobiologic, cognitive, psychological, and social repercussions of this illness [1]. Multiple seizures during a 24-hour period are included provided the child returns to baseline consciousness between episodes, according to the International League against Epilepsy (ILAE) definition [2].…”

Section: Introductionmentioning

confidence: 99%

Study of Cognitive and Behavioral Impacts of Idiopathic Epilepsy and Antiepileptic Drugs (AEDs) in Children and Adolescents

Aboeisa

Seleem

Gohary

et al. 2022

JAMMR

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Background: Epilepsy is a common neurological condition that can have a detrimental impact on social, emotional, and cognitive functioning. Psychiatric and cognitive problems in children with epilepsy and antiepileptic drugs can affect quality of life. Long-term follow-up studies reveal that epilepsy that develops in childhood is more common than epilepsy that develops later in life. Has a marked impact on adult life even when the epilepsy is not complicated by intellectual disability or other neurological impairments. The aim of this study was to study cognitive and behavioral impacts of idiopathic epilepsy and antiepileptic drugs in children and adolescents compared to normal ones. Methods: This prospective, case control study was conducted on 60 children or adolescents suffering from idiopathic epilepsy aged 6-16 years. Children were classified into four equal groups and were examined after 6 months from diagnosis: Group A subjected to valproic acid at a dose of 10-60 mg/kg/day, group B subjected to Carbamazepine at a dose of 10-30 mg/kg/day, group C subjected to levetiracetam at a dose of 10-60 mg/kg/day and group D subjected to Oxcarbazepine at a dose of 20-30 mg/kg/day. Thirty healthy children or adolescents of matched age and sex served as a control group who attended Pediatric General Outpatient Clinic of Tanta University Hospitals. The following was done to all of the patients: full history taking, complete physical examination, routine laboratory investigations, electroencephalography, brain magnetic resonance imaging, specific tests for behavior and executive functions including the Child Behavior Checklist – school age, Stanford-Binet Intelligence Scales (fifth version), Wisconsin Card Sorting Test and Continuous Performance Test. Thirty healthy children or adolescents of matched age and sex served as a control group. Results: Children with epilepsy who were treated with AEDs showed higher behavioral problems scales, lower mean IQ and lower executive functions as compared to controls. LEV and VPA had a more negative effect on behavior than CBZ and OXC while VPA and CBZ had a more negative effect on mean IQ and executive functions than LEV and OXC. Conclusion: Antiepileptic drugs (AEDs) may be one of the causes of epilepsy-related cognitive and behavioral issues in children.

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Prognosis of adults and children following a first unprovoked seizure

Cited by 5 publications

References 22 publications

Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America

Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America

Prognostic factors predicting an unprovoked seizure recurrence in children and adults following a first unprovoked seizure

Study of Cognitive and Behavioral Impacts of Idiopathic Epilepsy and Antiepileptic Drugs (AEDs) in Children and Adolescents

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