title: Epidemiology of early stages of epilepsy: Risk of seizure recurrence after a first seizure.
abstract: A single unprovoked seizure is a frequent phenomenon in the general population and the rate of seizure recurrence can vary widely. Individual risk prognostication is crucial in predicting patient outcomes and guiding treatment decisions. In this article, we review the most important risk factors associated with an increased likelihood of seizure recurrence after a single unprovoked seizure. In summary, the presence of focal seizure, nocturnal seizure, history of prior brain injury, family history of epilepsy, abnormal neurological exam, epileptiform discharges on electroencephalography and neuroimaging abnormalities, portend increased risk of seizure recurrence. Elucidation of these risk factors in patient assessment will augment clinical decision-making and may help determine the appropriateness of instituting anti-epilepsy treatment. We also discuss the Canadian model of single seizure clinics and the potential use to assess these patients.
authors.affiliation: Saskatchewan Epilepsy Program, Division of Neurology, Department of Medicine, University of Saskatchewan, Saskatoon, Canada.
authors.forename: Syed
authors.initials: S
authors.lastname: Rizvi
authors.affiliation: Neurology Section, Epilepsy Program, Hospital Pablo Tobón Uribe, University of Antioquia, Medellín, Colombia.
authors.forename: Lady Diana
authors.initials: LD
authors.lastname: Ladino
authors.affiliation: Saskatchewan Epilepsy Program, Division of Neurology, Department of Medicine, University of Saskatchewan, Saskatoon, Canada.
authors.forename: Lizbeth
authors.initials: L
authors.lastname: Hernandez-Ronquillo
authors.affiliation: Saskatchewan Epilepsy Program, Division of Neurology, Department of Medicine, University of Saskatchewan, Saskatoon, Canada. Electronic address: jftellez@yahoo.com.
authors.forename: José F
authors.initials: JF
authors.lastname: Téllez-Zenteno
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D012008:Recurrence; D012307:Risk Factors; D012640:Seizures / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000927:Anticonvulsants
keywords: Diagnosis; Epidemiology; First seizure; Recurrence; Single seizure; Unprovoked seizure