title: Are afebrile seizures associated with minor infections a single seizure category? A hospital-based prospective cohort study on outcomes of first afebrile seizure in early childhood.
abstract: OBJECTIVE
  To explore if afebrile seizures associated with minor infections are a single category of seizure, or a set of different kinds of seizures.
  
  
  METHODS
  We conducted this prospective cohort study on three kinds of first afebrile seizure: first afebrile seizure associated with gastrointestinal infection (AS-GI), first afebrile seizure associated with nongastrointestinal infection (AS-nGI), and first unprovoked seizure (US). The Kaplan-Meier estimate risks of recurrent seizures were analyzed and compared pairwise. The characteristics of recurrent seizures were also compared pairwise.
  
  
  RESULTS
  The Kaplan-Meier estimate risks of recurrent seizure at 2 years of the AS-GI, AS-nGI, and US groups were 6.9%, 23.7%, and 37.8%, respectively. The pairwise differences were significant between the AS-GI and US groups (p < 0.001) and between the AS-GI and AS-nGI groups (p = 0.001), but not significant between the US and AS-nGI groups (p = 0.066). Among unprovoked subsequent seizures in patients with recurrence, the pairwise differences were significant between the AS-GI and US groups (p < 0.001) and between the AS-GI and AS-nGI groups (p = 0.005), but not significant between the US and AS-nGI groups (p = 0.417).
  
  
  CONCLUSIONS
  Afebrile seizures associated with minor infections are indeed of two distinguishable kinds: AS-GI, if free of risk factors such as a family history of epilepsy, had a better prognosis and should be categorized as an acute symptomatic seizure, whereas patients with first AS-nGI, like patients with first US, may have recurrent unprovoked seizures, which suggests this category's essential difference from AS-GI.
authors.affiliation: Department of Rehabilitation, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Zhang
authors.forename: Jiannan
authors.initials: J
authors.lastname: Ma
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Gan
authors.forename: Nong
authors.initials: N
authors.lastname: Xiao
mesh_terms: D015331:Cohort Studies; D042241:Early Diagnosis; D004569:Electroencephalography / Q000639:trends; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005759:Gastroenteritis / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006776:Hospitals, Pediatric / Q000639:trends; D006801:Humans; D007223:Infant; D007239:Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome
keywords: Afebrile seizures; Child; Epilepsy; First seizure; Gastroenteritis; Recurrence