Short-term risk of recurrence after a first unprovoked seizure - 27/03/18
Résumé |
Introduction |
The rate and predictive factors of short-term recurrences are not known. There are a lot of literatures illustrating the risk of recurrence especially in mid-long-term risk. SFN suggests a consultation with a neurologist at the delay of one month to avoid misdiagnosis.
Objectives |
First objective: to evaluate the risk of recurrence after a first unprovoked seizure at one month. Secondary objective: The associative risk factors of recurrence at 1 month and the recurrence risk at 3 months.
Methods |
This is a prospective observational study based on a consecutive series of 140 adult patients admitted in ED for a first unprovoked seizure during one year. All the included patients were followed in a specialized consultation at 1 month. The collected data was exhaustive including: demographic criteria, clinical examination, recurrence at 1 and 3 months, EEG, imaging, precipitating factors, type of seizure and prescribed treatment.
Résultats |
Among the 140 patients diagnosed as first unprovoked seizure by the ED, only 80 patients have their diagnosis confirmed by the specialist at the consultation performed at 1 month. Nine patients had recurrence before the specialized consultation at one month (11%). We were able to define specific valid risk factors of short-term recurrence (less than 1 month): focal seizure (P=0.015), abnormal EEG in the first 48hours as focal slowness (P=0. 058) and imaging abnormalities (P=0.19).
Discussion |
Our study is the first project addressing the question of the short term recurrence risk of seizure after a first unprovoked event. Our results for the risk of recurrence at 3 months are compatible with most of literature. This emphasizes the importance of a specialized consultation to verify the appropriate diagnosis. The ED should be devoted only in the differential diagnosis workup.
Conclusion |
The risk of early recurrence at one month after an unprovoked seizure is estimated at 11%. Most of the patients came in the ED does not had any recurrence seizure in the first month. The risk factors are: EEG, type of seizure and imaging. The delay of 1 month is safe.
Le texte complet de cet article est disponible en PDF.Mots clés : Épilepsie, Risque de récidive, Première crise d’épilepsie non provoquée
Plan
Vol 174 - N° S1
P. S18 - avril 2018 Retour au numéro
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