Recurrence after a first unprovoked seizure. Is it still a controversial issue? First Seizure Trial Group (first).
The decision whether or not to start anticonvulsant treatment after a first unprovoked seizure is still an individual one for the patient concerned. Reliable estimates of the risk of seizure recurrence and identification of patients at a higher risk of recurrence are lacking, as critical comparison of studies is limited by the diversity of the target populations and study designs in published studies. The present review interprets the rates of recurrence after a first unprovoked seizure and prognostic factors and predictors of recurrence in the light of the methods used in individual published studies of seizure recurrence. The impact of drug treatment on the prognosis of the first seizure (prevention of recurrence and enhancement of long-term remission) is also assessed.
Beghi
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CNR, Istituto di Tecnologie Biomediche Avanzate, Milan, Italy.
Ciccone
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D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D004569:Electroencephalography / Q000187:drug effects; D004827:Epilepsy / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D012008:Recurrence; D012307:Risk Factors
D000927:Anticonvulsants