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How long do new-onset seizures in children last?
S Shinnar1, A T Berg, S L Moshe
1Department of Neurology, Montefiore Medical Center, The Albert Einstein College of Medicine, Bronx, NY 10467, USA.
Annals of Neurology
|May 19, 2001
Summary
In children experiencing their first unprovoked seizure, 50% lasted 5 minutes or longer. Prolonged seizures are likely to continue, indicating a need for intervention after 5-10 minutes.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Epidemiology
Background:
- Limited data exist on seizure duration in nonrefractory epilepsy.
- Understanding seizure duration is crucial for timely intervention.
Purpose of the Study:
- To determine the distribution of seizure duration in children with a first unprovoked seizure.
- To analyze the conditional probability of seizure cessation over time.
Main Methods:
- Prospective study of 407 children with a first unprovoked seizure.
- Data collection via structured interviews and medical/ambulance record review.
- Statistical analysis of seizure duration distribution and conditional probabilities.
Main Results:
- 50% of seizures lasted >= 5 minutes, 29% >= 10 minutes, 16% >= 20 minutes, and 12% >= 30 minutes.
- Seizure duration followed a biexponential distribution, with 76% having a short mean duration (3.6 min) and 24% a longer mean duration (31 min).
- The likelihood of spontaneous cessation decreased significantly as seizure duration increased.
Conclusions:
- Seizure duration in children with first unprovoked seizures differs from refractory epilepsy populations.
- A subset of children are predisposed to prolonged seizures.
- Intervention is indicated for seizures lasting >5-10 minutes; current status epilepticus definition (>=30 min) is supported for epidemiology.