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The First Unprovoked Seizure in Typically Developing Children: A Real-Life Setting in Southern Brazil
Mayara de Rezende Machado1, Isac Bruck2, Luciano de Paola1
1Department of Internal Medicine, Federal University of Paraná, Curitiba, Brazil.
Insights
First unprovoked seizures in Brazilian children show a high recurrence rate, with younger age being a potential risk factor. Further research into early-onset seizures is warranted.
Area of Science:
- Pediatric Neurology
- Epileptology
Background:
- First unprovoked seizures in children require understanding of clinical patterns and outcomes.
- Real-world data on seizure characteristics and recurrence in diverse populations are crucial.
Purpose of the Study:
- To characterize the first unprovoked seizure in typically developing children in Southern Brazil.
- To determine the recurrence rate and identify potential risk factors for these seizures.
Main Methods:
- Retrospective cohort study of medical records from children aged 28 days to 14 years.
- Data collected over a 10-year period (2006-2016) from a single tertiary care center.
- Analysis included clinical presentation, electroencephalogram (EEG), neuroimaging, and follow-up data.
Main Results:
- 74 children (41 males, 33 females) were analyzed.
- Focal seizures were most common (50%), often occurring while awake (70%).
- The seizure recurrence rate was 56.7%, with younger age (<5 years) identified as a possible risk factor.
Conclusions:
- A significant proportion of typically developing Brazilian children experience recurrent unprovoked seizures.
- While abnormal EEG findings were common, they did not correlate with increased recurrence risk.
- Age under 5 years may indicate a need for closer monitoring and follow-up in pediatric epilepsy management.
Aim:
To describe the first unprovoked seizure in typically developing children, its clinical characteristics, recurrence rate, and possible risk factors in a real-life setting in Southern Brazil.
Method:
In this retrospective cohort study, medical records of typically developing children aged 28 days to 14 years who had a first unprovoked seizure in a single tertiary care center were reviewed, in a 10-year period (2006-2016).
Results:
Seventy-four children were included, 41 males and 33 females. The most frequent age group of the first seizure was 5 to 10 years and seizure main type was focal (50%). Most seizures occurred while children were awake (70%). All patients underwent an electroencephalogram (EEG), which was normal in 44.6%. Neuroimaging was performed in 81%, in 2 cases the etiology was considered structural, the remaining was classified as unknown. Median follow-up period was 32.5 months. Seizure recurrence rate was 56.7% and age younger than 5 years was a possible risk factor.
Interpretation:
In the subpopulation of Brazilian typically developing children with a first unprovoked epileptic seizure there is a high recurrence rate. An abnormal EEG was a common finding, although it was not associated with a higher risk of seizure recurrence. A possible risk factor was age younger than 5 years, which may suggest a more rigorous follow-up of these patients.
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