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Clinical profile and long-term outcome of the first seizures in children
Pınar Arıcan1, Hakan Salman2, Nihal Olgaç Dündar3
1Department of Pediatric Neurology, Kahramanmaraş Necip Fazil Hospital, Kahramanmaraş.
Insights
First seizures in children can lead to epilepsy, especially unprovoked seizures. Prompt diagnosis and treatment are crucial for managing pediatric seizure outcomes and preventing long-term conditions like epilepsy.
Area of Science:
- Pediatric Neurology
- Clinical Medicine
- Epileptology
Background:
- Seizures are a frequent reason for pediatric hospital admissions.
- Understanding the clinical profile and outcomes of first-time seizures in children is critical.
Purpose of the Study:
- To identify the clinical characteristics and outcomes of first seizures in children.
- To differentiate outcomes based on seizure types: febrile, nonfebrile-provoked, and unprovoked seizures.
Main Methods:
- A cohort of 138 children (1 month to 18 years) presenting with their first seizure was enrolled.
- Patients were classified into three groups: febrile seizure, nonfebrile-provoked seizure, and unprovoked seizure.
- Follow-up assessments were conducted at 18 months and 8 years to evaluate seizure recurrence and epilepsy development.
Main Results:
- 60% of children experienced febrile seizures, 17% nonfebrile-provoked, and 40% unprovoked seizures.
- Children with nonfebrile-provoked seizures did not develop epilepsy within 8 years.
- A significant proportion (60% at 18 months, 82% at 8 years) of children with unprovoked seizures experienced recurrence, with higher rates in those with abnormal EEG and MRI findings.
Conclusions:
- Provoked first seizures in children do not typically lead to epilepsy.
- Unprovoked first seizures carry a substantial risk of recurrence and progression to epilepsy.
- Identifying the underlying cause of seizures and initiating appropriate treatment is essential for managing pediatric epilepsy.
Background:
Seizures are one of the most common causes of pediatric admissions to hospitals in children. This study aims to identify the clinical profile and outcome of first seizures in children.
Methods:
Children who presented to the pediatric neurology outpatient clinic and pediatric emergency service with a first-time seizure and aged one month through 18 years old were enrolled to the study. At the time of the study, enrolled children were categorized into three study groups according to seizure characteristics: febrile seizure, nonfebrile-provoked seizure and, unprovoked seizure.
Results:
The study group consisted of 138 children. Of the 138 patients, 60 (43%) had febrile first seizures, 23 (17%) had nonfebrile-provoked first seizures, and 55 (40%) had unprovoked first seizures. The patients did not experience the recurrence of a seizure by the treatment of underlying cause at the eighteenth month and the eighth year follow-up in the nonfebrile-provoked seizure group. Among the children admitted for unprovoked first seizures, 33 (60%) patients had seizure recurrence during 18 month follow-up and 36 (82%) patients had seizure recurrence during eight year follow-up. Seizure recurrence rate was statistically higher in patients with abnormal EEG and cranial MRI findings in the unprovoked seizure group (p < .05).
Conclusions:
The patients with provoked first seizure did not develop epilepsy during eight year follow-up. However, 36 patients with unprovoked seizures were diagnosed with epilepsy during eight year follow-up. It is essential to determine the causes of the seizures and treat the condition.
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