Clinical profile and long-term outcome of the first seizures in children.

BACKGROUND Seizures are one of the most common causes of pediatric admissions to hospitals in children. This study aims to identify the clinical profile and outcome of first seizures in children. METHODS Children who presented to the pediatric neurology outpatient clinic and pediatric emergency service with a first-time seizure and aged one month through 18 years old were enrolled to the study. At the time of the study, enrolled children were categorized into three study groups according to seizure characteristics: febrile seizure, nonfebrile-provoked seizure and, unprovoked seizure. RESULTS The study group consisted of 138 children. Of the 138 patients, 60 (43%) had febrile first seizures, 23 (17%) had nonfebrile-provoked first seizures, and 55 (40%) had unprovoked first seizures. The patients did not experience the recurrence of a seizure by the treatment of underlying cause at the eighteenth month and the eighth year follow-up in the nonfebrile-provoked seizure group. Among the children admitted for unprovoked first seizures, 33 (60%) patients had seizure recurrence during 18 month follow-up and 36 (82%) patients had seizure recurrence during eight year follow-up. Seizure recurrence rate was statistically higher in patients with abnormal EEG and cranial MRI findings in the unprovoked seizure group (p < .05). CONCLUSIONS The patients with provoked first seizure did not develop epilepsy during eight year follow-up. However, 36 patients with unprovoked seizures were diagnosed with epilepsy during eight year follow-up. It is essential to determine the causes of the seizures and treat the condition.

[1]  A. Frigo,et al.  First‐ever convulsive seizures in children presenting to the emergency department: risk factors for seizure recurrence and diagnosis of epilepsy , 2018, Developmental medicine and child neurology.

[2]  Anwar E. Ahmed,et al.  Prognostic factors for epilepsy following first febrile seizure in Saudi children , 2017, Annals of Saudi medicine.

[3]  S. Aronoff,et al.  Systematic Review and Meta-analysis of Seizure Recurrence After a First Unprovoked Seizure in 815 Neurologically and Developmentally Normal Children , 2017, Journal of child neurology.

[4]  J. Jirsch,et al.  Evaluation of the first seizure patient: Key points in the history and physical examination , 2017, Seizure.

[5]  D. Debicki.  Electroencephalography after a single unprovoked seizure , 2017, Seizure.

[6]  D. Ferriero,et al.  Swaiman's Pediatric Neurology: Principles and Practice , 2017 .

[7]  A. Abdelalim,et al.  The long-term prognosis of newly diagnosed epilepsy in Egypt: A retrospective cohort study from an epilepsy center in Greater Cairo , 2016, Seizure.

[8]  Shumei S. Sun,et al.  Risk factors for subsequent febrile seizures in the FEBSTAT study , 2016, Epilepsia.

[9]  A. Ojha,et al.  Clinico-etiological profile of children with seizures admitted in a tertiary centre , 2016 .

[10]  B. Sathian,et al.  Profile of children admitted with seizures in a tertiary care hospital of Western Nepal , 2013, BMC Pediatrics.

[11]  P. Beleza.  Acute Symptomatic Seizures: A Clinically Oriented Review , 2012, The neurologist.

[12]  P. Singhi,et al.  Management of Acute Seizure and Status Epilepticus in Pediatric Emergency , 2012, The Indian Journal of Pediatrics.

[13]  D. Christakis,et al.  Redefining Outcome of First Seizures by Acute Illness , 2010, Pediatrics.

[14]  J. H. Cross,et al.  Revised terminology and concepts for organization of seizures and epilepsies: Report of the ILAE Commission on Classification and Terminology, 2005–2009 , 2010, Epilepsia.

[15]  A. Berg,et al.  Risk of recurrence after a first unprovoked seizure , 2008, Epilepsia.

[16]  Jaishree T. Narayanan,et al.  New-onset acute symptomatic seizure in a neurological intensive care unit. , 2007, Neurology India.

[17]  G. Sharieff,et al.  Seizures in children. , 2006, Pediatric clinics of North America.

[18]  Bernd Pohlmann-Eden,et al.  The first seizure and its management in adults and children , 2006, BMJ : British Medical Journal.

[19]  B. Pohlmann-Eden,et al.  Value of the Early Electroencephalogram after a First Unprovoked Seizure , 2003, Clinical EEG.

[20]  Y. Al-Eissa,et al.  Febrile Seizures: Rate and Risk Factors of Recurrence , 1995, Journal of child neurology.

[21]  Ingrid E Scheffer,et al.  Febrile seizures , 2007, BMJ : British Medical Journal.

[22]  W. Hauser.  The Prevalence and Incidence of Convulsive Disorders in Children , 1994, Epilepsia.

[23]  J. Kaushik,et al.  How I treat a first single seizure in a child , 2016, Annals of Indian Academy of Neurology.

[24]  P. Poudel,et al.  Clinical profile, aetiology and outcome of afebrile seizures in children. , 2013, JNMA; journal of the Nepal Medical Association.

[25]  J. Stockman.  Course and outcome of childhood epilepsy: A 15-year follow-up of the Dutch Study of Epilepsy in Childhood , 2012 .