Recurrence risk after a first remote symptomatic unprovoked seizure in childhood: a prospective study.
The aim of this study was to assess recurrence risk after a first remote symptomatic unprovoked seizure in childhood. All consecutive patients younger than 14 years with a first remote symptomatic unprovoked seizure who were seen at our hospital between 1994 and 2006 were included in the study and prospectively followed. Only two patients received antiepileptic treatment. Sixty-three children were included, with 35 males and 28 females. Mean age at first seizure was 4 years (SD 3y 5mo). Kaplan-Meier estimate of recurrence risk was 59% (95% confidence interval [CI] 47-71), 76% (95% CI 65-87), 85% (95% CI 76-94), and 87% (95% CI 78-96) at 6, 12, 18, and 24 months respectively. A total of 55 children out of 63 were affected by a static encephalopathy of pre- or perinatal origin. In this subgroup, recurrence risk at 12 and 24 months was 79% (95% CI 68-90) and 89% (95% CI 80-98). Univariable analysis using the Cox proportional hazards model showed that presence of global developmental delay/intellectual disability and Todd's paresis were associated with a significant increase in recurrence risk. In multivariable analysis, only Todd's paresis was significantly associated. Recurrence risk after a first remote symptomatic unprovoked seizure in childhood is much higher than what some previous studies suggests.
Ramos-Lizana
J
J
Paediatric Neurology Unit, Department of Paediatrics, Torrecárdenas Hospital, Almería, Spain. jramoslizana@telefonica.net
Aguirre-Rodríguez
J
J
Aguilera-López
P
P
Cassinello-García
E
E
D001925:Brain Damage, Chronic / Q000151:congenital / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology; D004827:Epilepsy / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000453:epidemiology / Q000209:etiology; D053208:Kaplan-Meier Estimate; D008297:Male; D010243:Paralysis / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012008:Recurrence; D012306:Risk; D012640:Seizures / Q000453:epidemiology* / Q000209:etiology; D013030:Spain; D013223:Statistics as Topic