Risk Factors of Early Seizure Recurrence in Epileptic Patients Presented to an Emergency Department in Hong Kong

Introduction While epilepsy is a well-known disease, little is known about early recurrence of seizures, and some patients are admitted to medical ward for the risk of recurrence of epilepsy. The aim of this study was to determine the frequency and risk factors of early seizure recurrence (ESR) among the epileptic adult patients attending the emergency department (ED). Methods In this retrospective observational study, medical records of all patients presenting to a regional ED in Hong Kong with seizures from 1 January 2010 to 31 December 2011 were reviewed. Their demographic data and clinical features were analysed to look for the relationship with ESR. ESR was defined as a seizure recurrence during the first 24 hours since the last seizure. Results A total of 339 patient records were analysed. The ESR rate was 13.7% at 24 hours and 80% occurred in the first six hours after the last seizure. Age≥40, female sex, repeated seizure in past one day, and abnormal plasma sodium and calcium levels were found to be statistically significantly associated with ESR by univariate analysis. These risk factors remain statistically significant after repeated multivariate logistic regression analysis. Conclusion The ESR rate is about 13.7% in our emergency department setting and 80% of them occur within six hour since their last seizure. Five risk factors, namely age group, sex, repeated seizure in past one day and abnormal blood sodium and calcium level are significant factors associated with ESR. We conclude that it is not necessary to admit all the adult epileptic patients with simple breakthrough seizures to hospital. (Hong Kong j.emerg.med. 2014;21:37-43)