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[First epileptic crisis. Analysis of risk factors for recurrence]
A E Scotoni1, M M Guerreiro, H J De Abreu
1Neuropediatra do Hospital das Clínicas da Universidade Estadual de Campinas (UNICAMP), Brasil.
Insights
Children with a first seizure face a recurrence risk influenced by abnormal electroencephalogram (EEG) and a family history of unprovoked seizures. These factors significantly increase the likelihood of further seizure events.
Area of Science:
- Pediatric Neurology
- Epilepsy Research
- Clinical Risk Factor Analysis
Context:
- Investigated risk factors for seizure recurrence in children presenting with their first seizure.
- Focused on idiopathic epilepsy cases from a pediatric outpatient clinic.
- Data collected between September 1989 and July 1996.
Purpose:
- To assess univariable and multivariable risk factors associated with seizure recurrence.
- Identify specific predictors of epilepsy progression in pediatric patients.
- Determine the long-term recurrence rates after a first unprovoked seizure.
Summary:
- Analyzed 86 children with idiopathic epilepsy, finding a 33% recurrence rate over 2.4 years.
- Abnormal electroencephalogram (EEG) and a family history of unprovoked seizures were identified as significant risk factors for recurrence (p < 0.003).
- Survival analysis estimated recurrence rates at 18% (6 months), 27% (1 year), 35% (2 years), and 38% (3 years).
Impact:
- Highlights the prognostic value of EEG and family history in managing pediatric epilepsy.
- Informs clinical decision-making regarding monitoring and intervention strategies for children with first-time seizures.
- Provides crucial data for understanding epilepsy natural history and recurrence patterns in childhood.
Abstract:
We studied children who presented with a first seizure and came to the outpatient clinic for childhood from September/1989 to July/1996. The following risk factors were assessed: age, sex, type and etiology of the seizure, sleep state at time of seizure, family history of seizures, electroencephalogram (EEG) and computerized tomography (CT). Our purpose was to assess the risk factors in univariable and multivariable analysis. We found two groups of patients according to the etiology: (a) idiopathic cases (IC) and (b) symptomatic cases (SC). This last group had only two patients and was excluded from the analysis. We studied only the IC group with 86 patients. Seizure recurrence was observed 29 children (33%), during 2.4 years. Only patients with abnormal EEG and family history for unprovoked seizures had a higher risk of recurrence (p < 0.003). After the first unprovoked seizure estimate of recurrence by survival curves was 18% at first semester, 27% at first year, 35% at second year and 38% at third year.