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Recurrence, remission, and relapse of seizures
1Department of Neurology, Cleveland Clinic Foundation, OH 44195.
Cleveland Clinic Journal of Medicine
|November 1, 1993
Summary
Antiepileptic drugs halve seizure recurrence risk but have side effects. Prognostic factors like neurologic abnormalities influence seizure recurrence and remission, guiding treatment decisions.
Area of Science:
- Neurology
- Clinical Medicine
Background:
- Approximately 6% of the population experiences at least one afebrile seizure in their lifetime.
- Understanding seizure recurrence and remission is crucial for patient management.
Purpose of the Study:
- To review prognostic factors influencing seizure recurrence, remission, and relapse.
- To discuss the clinical implications of these factors in seizure management.
Main Methods:
- Literature review of studies on seizure prognosis.
- Analysis of factors affecting seizure recurrence and remission.
- Evaluation of antiepileptic drug treatment efficacy and risks.
Main Results:
- Antiepileptic drug treatment approximately halves the risk of seizure recurrence after a first seizure.
- Risk of recurrence is elevated with neurologic or electroencephalographic abnormalities and partial seizures.
- Neurologic abnormalities and partial seizures decrease the likelihood of remission.
Conclusions:
- Antiepileptic drugs offer benefits but carry adverse effects.
- Prognostic indicators guide decisions on initiating or discontinuing therapy.
- Gradual drug withdrawal may be considered after 2 years of remission without negative prognostic signs.