title: The value of 24-hour video-EEG in evaluating recurrence risk following a first unprovoked seizure: A prospective study.
abstract: OBJECTIVE
  To evaluate the value of 24-hour video-EEG (VEEG) in assessing recurrence risk after a first unprovoked seizure.
  
  
  METHODS
  Consecutively 134 patients with a first unprovoked epileptic seizure were recuited from West China Hospital, Sichuan University, between January 2010 and January 2013. All patients underwent VEEG and magnetic resonance imaging (MRI) of the brain, Each patient had at least 24-month follow up.
  
  
  RESULTS
  Seventy-six (56.7%) patients had abnormal VEEG, and VEEG abnormalities was associated with an increased risk of seizure recurrence (RR 2.84, 95% CI 1.67-4.82, p<0.001). The overall accumulated seizure recurrence risks were 51.5% in all patients, and 45.6% in generalized seizures subgroup, and with no significant difference. The subgroup of VEEG with epileptiform discharges had an increased seizure recurrence risk compared with normal VEEG (RR 2.76, 95% CI 1.83-5.34, P<0.001) and the nonsignificant abnormality VEEG group (RR 2.05, 95% CI 1.14-3.82, P<0.001). Within the group of whom showed epileptiform discharges, the recurrence rate of those with generalized epileptiform discharge abnormality and focal epileptiform discharge abnormality were not significantly different (RR 1.09, 95% CI 0.44-2.69, P=0.85).
  
  
  CONCLUSIONS
  An abnormal VEEG is a risk factor for seizure recurrence in patients with a first unprovoked seizure, especially if epileptiform discharges past. The recurrence risks were 73.2% in the epileptiform discharges abnormality VEEG group, which may help the diagnosis of epilepsy according to the practical clinical definition of epilepsy.
authors.affiliation: Department of Neurology, West China Hospital, West China Medical School, Sichuan University, 17th, Wai Nan Guo Xue Lane, Chengdu 610041, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Neurology, West China Hospital, West China Medical School, Sichuan University, 17th, Wai Nan Guo Xue Lane, Chengdu 610041, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Si
authors.affiliation: Department of Neurology, West China Hospital, West China Medical School, Sichuan University, 17th, Wai Nan Guo Xue Lane, Chengdu 610041, China.
authors.forename: Deng
authors.initials: D
authors.lastname: Chen
authors.affiliation: Department of Neurology, West China Hospital, West China Medical School, Sichuan University, 17th, Wai Nan Guo Xue Lane, Chengdu 610041, China.
authors.forename: Lina
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Neurology, West China Hospital, West China Medical School, Sichuan University, 17th, Wai Nan Guo Xue Lane, Chengdu 610041, China.
authors.forename: Da
authors.initials: D
authors.lastname: Xu
authors.affiliation: Department of Neurology, West China Hospital, West China Medical School, Sichuan University, 17th, Wai Nan Guo Xue Lane, Chengdu 610041, China.
authors.forename: Sihan
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Neurology, West China Hospital, West China Medical School, Sichuan University, 17th, Wai Nan Guo Xue Lane, Chengdu 610041, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhou
authors.affiliation: Department of Neurology, West China Hospital, West China Medical School, Sichuan University, 17th, Wai Nan Guo Xue Lane, Chengdu 610041, China. Electronic address: zjllxx2015@163.com.
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods* / Q000592:standards; D004828:Epilepsies, Partial / Q000175:diagnosis*; D004829:Epilepsy, Generalized / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064926:Neurophysiological Monitoring / Q000379:methods* / Q000592:standards; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012640:Seizures / Q000175:diagnosis*; D014741:Video Recording; D055815:Young Adult
keywords: Epilepsy; First unprovoked seizure; Recurrence rate; Risk factors; Video-EEG