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Knowledge of the recurrence risk following a first unprovoked seizure and the predictors of that risk are necessary for rational treatment decisions.Published estimates of recurrence risk range from 23%to 71%.In a meta-analysis of 16 reports,three methodologic factors explained much of the reported variation:(1)study inclusion criteria,ie,whether patients were enrolled at the time of their first seizure or if patients with prior seizures were included;(2)retrospective versus prospective ascertainment of patients;(3)the interval between the first seizure and the time at which risk was assessed.The average recurrence risk across the 16 studies was 51%.The risk was 40%and 52%in prospective and retrospective studies that employed first-seizure methods and 67%in non-first seizure studies.At or near 2 years following the first seizure,the recurrence risk was 36%and 47%in prospective and retrospective first-seizure studies.The distribution of prognostic factors was also important.Seizure etiology and the EEG were the strongest predictors of recurrence distinguishing between patient subgroups,with recurrence risks as low as 24%and as high as 65%.Partial seizures were associated with an increased recurrence risk,but not consistently.There is considerable agreement among studies concerning the recurrence risk following a first seizure,and much of the discrepancies among studies can be explained by differences in study methods and distributions of important prognostic factors. |
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review article
risk factors
seizure
seizure,prognosis in adults
seizure,prognosis in childhood
seizure,risk factors for
seizure,treatment of
seizure,treatment of,first
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