1. Short-term risk of recurrence after a first unprovoked seizure
- Author
-
Louise Tyvaert, Walid Alesefir, Centre de Recherche en Automatique de Nancy (CRAN), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Service de neurologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Maquin, Didier, and Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL)
- Subjects
Pediatrics ,medicine.medical_specialty ,Early Recurrence ,Physical examination ,Electroencephalography ,Recurrence risk ,03 medical and health sciences ,0302 clinical medicine ,medicine ,[SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,Première crise d’épilepsie non provoquée ,030212 general & internal medicine ,Épilepsie ,medicine.diagnostic_test ,Adult patients ,Risque de récidive ,business.industry ,3. Good health ,Neurology ,[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,Observational study ,Neurology (clinical) ,Differential diagnosis ,business ,030217 neurology & neurosurgery ,Abnormal EEG - Abstract
Résumé publié dans Revue Neurologique 174(S1):S18, April 2018; National audience; 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 48 hours 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.
- Published
- 2018
- Full Text
- View/download PDF