[Prospective study of first unprovoked seizure]

We prospectively examined the natural history of children who suffered a first unprovoked seizure (FUS). Forty-five children who suffered a seizure without any detectable precipitating factors were enrolled in this study. Absence seizure, myoclonic seizure, and epileptic spasms were excluded from this study. They were followed for at least 2 years without anti-epileptic medications in 43 cases (2 were given drugs). Thirty patients (66.7%) had another seizure during follow up. Of the 30 patients with recurrence, 11 suffered the second seizure within 1 month, 19 within 3 months, 24 within 6 months, 26 within 1 year, and 30 within 2 years. Occurrence of generalized convulsions, a past history and family history of febrile seizures, epileptic discharges on the EEG (especially a diffuse pattern), and developmental delay prior to the FUS were risk factors for seizure recurrence. Up to one third of the patients had no more recurrent seizures during the next 2 years, so it seems reasonable to follow FUS patients without medication.