Early treatment of a single generalized tonic-clonic seizure to prevent recurrence.
BACKGROUND
The question of whether to start antiepileptic treatment after a single unprovoked seizure remains controversial and has been the subject of much debate in the relevant literature.


OBJECTIVE
To determine the rate of recurrence of a second attack after a single unprovoked epileptic seizure by using 2 study groups of treated and untreated patients and, thus, to establish a treatment policy for these patients.


METHODS
A group of 91 patients with a single generalized tonic-clonic seizure were prospectively studied; 87 of these patients completed the study. The end point of the study was 36 months after the single attack or the occurrence of a subsequent epileptic attack. The patients were randomly divided into 2 groups; 45 patients who immediately received anticonvulsive treatment and 42 who remained untreated for the follow-up period. Patients in the treated group were given monotherapy with carbamazepine. The results of recurrences were statistically analyzed by using the Kaplan-Meier method.


RESULTS
Results indicated a significantly higher percentage of seizure-free patients in the treated group compared with that in the untreated group (P = .001). The treated men were proved to be less at risk for recurrent seizures compared with treated women (P < .001 vs P = .03, respectively).


CONCLUSIONS
Treatment after a single unprovoked seizure leads to a significant reduction in the risk of relapse of generalized tonic-clonic epilepsy.
Gilad
R
R
Department of Neurology, Edith Wolfson Medical Center, Holon, Israel.
Lampl
Y
Y
Gabbay
U
U
Eshel
Y
Y
Sarova-Pinhas
I
I
D000328:Adult; D002220:Carbamazepine / Q000627:therapeutic use*; D004830:Epilepsy, Tonic-Clonic / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012008:Recurrence; D013997:Time Factors
D002220:Carbamazepine