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Acute symptomatic seizures are seizures closely related to neurological or systemic insults and represent about 40% of all first seizures. Operational diagnostic criteria have been recommended by the International League Against Epilepsy and are based on temporal relationship, severity, and type of insult. Antiepileptic drug prophylaxis is recommended in severe head trauma, preeclampsia, and possibly high-risk subarachnoid or intracranial hemorrhage. It is crucial to rapidly identify all insults possibly involved, treat underlying diseases, revert corrigible factors, and in case of central nervous system involvement, use antiepileptic drugs during the acute period. Risk of epilepsy is increased in patients with neurological insults but not with metabolic disorders. Some refractory epilepsies in adults, mostly epilepsy due to hippocampal sclerosis, are preceded by acute symptomatic seizures related to selected insults occurring at a specific time. Mortality rate is globally increased. |
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