Risk of Seizure Recurrence Following First Unprovoked Seizure Among Children in Nakhon Pathom: A Restrospective Study
Keywords:
first unprovoked seizure, children, risk factor, electroencephalogramAbstract
Objectives: The purpose is to investigate the recurrent risk factors of children with first unprovoked seizure.
Method: This is a retrospective analytic study. Medical records and electroencephalogram data of patients with first unprovoked seizure, aged 1 month to 15 years, admitted and followed up between 2018 and 2023 were analyzed. The total 75 patients were devided into 2 groups according to recurrent seizure. Multivariate Cox regression analysis was used to predict outcomes. A p-value of < .05 was considered statistically significant.
Results: Of the 75 patients, 53.3% were boys. The mean age at first seizure was 71.48 months. The rate of recurrence was 49.3%. The Kaplan-Meier estimate of cumulative risk of recurrence was 19.4% at 6 months and 27.1% at 12 months. Generalized seizure was reported in 73.3%. The duration of seizure was 1–4 minutes in 66.7%. Overall family history of epilepsy was 16%, in addition to delay milestone (9.3%), history of febrile seizure (18.7%), remote symptomatic seizure (5.3%), seizure during sleep (44%), and abnormal electroencephalogram (73.3%). Risk factors were identified. Multivariate Cox regression analysis revealed that recurrent seizure related to seizure during sleep (aHR, 2.21; 95% CI 1.11–4.39; p = .024) and abnormal electroencephalogram (aHR, 3.1; 95% CI 1.08–8.92; p = .036)
Conclusion: Most patients with first unprovoked seizure had no recurrence. The risk of recurrence was significantly higher when electroencephalogram showed abnormality and seizure occurring during sleep
References
Hauser WA, Beghi E. First seizure definitions and worldwide incidence and mortality. Epilepsia 2008;49(1):8–12. doi: 10.1111/j.1528-1167.2008.01443.x.
Maia C, Moreira AR, Lopes T, et al. Risk of recurrence after a first unprovoked seizure in children. J pediatr (Rio J) 2017;93(3):281–6. doi: 10.1016/j.jped.2016.07.001.
Boonluksiri P. Risk of recurrence following a first unprovoked seizure in Thai children. Neuro J southeast Asia 2003;8:25–29.
Berg AT, Shinnar S. The risk of seizure recurrence following a first unprovoked seizure: a quantitative review. Neurology 1991;41(7):965–72. doi: 10.1212/wnl.41.7.965.
Shinnar S, Berg AT, Moshe SL, et al. Risk of seizure recurrence following a first unprovoked seizure in childhood: a prospective study. Pediatrics 1990;85(6):1076–85.
Pereira C, Resende C, Fineza I, et al. A 15-year follow up of first unprovoked seizure: a prospective study of 200 children. Epileptic Disord 2014;16(1):50–5. doi: 10.1684/epd.2014.0643.
Daoud AS, Ajloni S, El-Salem K, et al. Risk of seizure recurrence after a first unprovoked seizure: a prospective study among Jordanian children. Seizure 2004;13(2):99–103. doi: 10.1016/s1059-1311(03)00137-7.
Berg AT. Risk of recurrence after a first unprovoked seizure. Epilepsia 2008;49(Suppl 1):13–18. doi: 10.1111/j.1528-1167.2008.01444.x.
งานเวชระเบียนและสถิติ. รายงานสถิติประจำปี 2558–2559 [เอกสารรายงาน]. นครปฐม: โรงพยาบาลนครปฐม: 2559.
Shinnar S, Berg AT, Moshe SL, et al. The risk of seizure recurrence after a first unprovoked afebrile seizure in childhood: an extended follow-up. Pediatrics 1996;98(2 Pt 1):216–25.
Inaloo S, Sadeghi E, Rafiee M, et al. Risk of seizure recurrence following a first unprovoked seizure in childhood. IRCMJ 2008;10(4):303–8.
Winckler MlB, Rotta NT. Clinical and electroencephalographic follow up after a first unprovoked seizure. Pediar Neurol 2004;30(3):201–6. doi: 10.1016/j.pediatrneurol.2003.08.002.
Winckler MI, Rotta NT. Prognostic factors for recurrence of a first seizure during childhood. Arq Neuropsiquiatr 1997;55(4):749–56. doi: 10.1590/s0004-282x1997000500011.
Mizorogi S, Kanemura H, Sano F, et al. Risk factors for recurrence in children after first unprovoked seizure. Pediar Int 2015;57(4):665–9. doi: 10.1111/ped.12600.
Hauser WA, Rich SS, Annegers F, et al. Seizure recurrence after a first unprovoked seizure: An extended follow up. Neurology 1990;40(8):1163–70. doi: 10.1212/wnl.40.8.1163.
Scotoni AE, Guerreiro MM, De Abreu HJ. First epileptic crisis. Analysis of risk factors for recurrence. Arq Neuropsiquiatr 1999;57(2):392–400. doi: 10.1590/s0004-282x1999000300009.
Zelano J. Recurrence risk after a first remote symptomatic seizure in adult: Epilepsy or not?. Epilepsia Open 2021;6(4):634–44. doi: 10.1002/epi4.12543
Hirtz D, Ashwal S, Berg A, et al. Practice parameter: evaluating a first nonfebrile seizure in children: report of the quality standards subcommittee of American academy of neurology, the child neurology, and the American epilepsy society. Neurology 2000;55(5):616–23. doi: 10.1212/wnl.55.5.616.
Dlugos DJ. An EEG should not be obtained routinely after first unprovoked seizure in childhood. Neurology 2000;55(6):898–9.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
