Seizure recurrence risk following a first seizure in neurologically normal children.
OBJECTIVE
To define seizure recurrence rates in normal children who had had a single seizure and to define electroencephalography (EEG) or magnetic resonance imaging (MRI) utility in predicting seizure recurrence.


METHODS
We studied 150 children (6 to 14 years) with a first afebrile, unprovoked seizure. Inclusion criteria were: Normal physical and neurological examination, undergone EEG and MRI studies of the brain, and followed for at least 27 months. These children participated in an ongoing prospective study of new onset seizures in childhood.


RESULTS
The seizure recurrence rate was 66.4%. An abnormal EEG had no association with seizure recurrence at 9, 18, or 27 months (p = 0.1806, p = 0.2792, and p = 0.2379, respectively). A "significant" MRI abnormality, which occurred in 16.0% of patients, was associated with an increased seizure recurrence risk at 9 months (p = 0.0389) but not at 18 or 27 months.


CONCLUSIONS
EEG findings poorly predict recurrence after a single seizure. The high rate of MRI abnormalities suggests that MRI may need consideration as a routine test to evaluate epilepsy in normal children.
Arthur
Todd M
TM
Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
deGrauw
Ton J
TJ
Johnson
Cynthia S
CS
Perkins
Susan M
SM
Kalnin
Andrew
A
Austin
Joan K
JK
Dunn
David W
DW
D000293:Adolescent; D001921:Brain / Q000503:physiopathology*; D002648:Child; D004569:Electroencephalography; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology* / Q000503:physiopathology*