1. Treatment of first tonic-clonic seizure does not affect mortality: long-term follow-up of a randomised clinical trial
- Author
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Leone, Ma, Vallalta, R, Solari, A, Beghi, E, Hauser, Wa, Fratiglioni, L, Bogliun, G, DEL FELICE, Alessandra, Aloisi, P, Marelli, A, Porto, C, Fusi, L, Francesconi, C, Gambaro, P, Basso, P, Freschi, R, Meregalli, S, Boati, E, Mamoli, A, Gavalotti, B, Camerlingo, M, Rottoli, Mr, Bottacchi, E, Carenini, L, Sironi, L, Casara, Gl, Vecchi, M, Covezzi, E, Tortorici, G, Franzoni, E, Marchiani, V, Moscano, F, Giuliani, G, Angeleri, Va, Polonara, S, Terziani, S, Quattrini, A, Ortenzi, A, Paggi, A, Iemolo, F, Geda, C, Ferrari, Gf, Binetti, Ma, Martini, A, Perenchio, Mt, Malvezzi, L, Tabladon, G, Severi, S, Zolo, P, Montano, V, Fassio, F, Vignolo, L, Pasolini, Mp, Antonini, L, De Maria, G, Rossi, G, Tonini, C, Cittani, D, Zagnoni, Pg, Clerici, D, Romeo, A, Viri, M, Lodi, M, Mazza, S, Vaccario, Ml, De Mattei, M, Cremo, R, Zaina, P, Gentile, S, Lovera, N, Piazza, D, Ravetti, C, Cavestro, C, Rosettani, P., Leone MA, Vallalta R, Solari A, Beghi E, FIRST Group [.., Franzoni E, and ]
- Subjects
Male ,Time Factors ,long-term follow-up ,Electroencephalography ,law.invention ,Epilepsy ,Randomized controlled trial ,law ,Recurrence ,Risk Factors ,Young adult ,Family history ,Child ,first tonic-clonic seizure ,medicine.diagnostic_test ,treatment ,clinical trial ,Middle Aged ,Magnetic Resonance Imaging ,first tonic–clonic seizure ,seizure ,Settore MED/26 - NEUROLOGIA ,Psychiatry and Mental health ,Treatment Outcome ,Child, Preschool ,Anticonvulsants ,Female ,Adult ,medicine.medical_specialty ,Adolescent ,antiepileptic treatment ,Neurological examination ,Young Adult ,Seizures ,Internal medicine ,medicine ,Humans ,business.industry ,medicine.disease ,mortality ,Surgery ,Clinical trial ,tonic-clonic seizure ,Etiology ,Neurology (clinical) ,business ,Tomography, X-Ray Computed ,Follow-Up Studies - Abstract
Information on the effects of early treatment of seizures on mortality is scarce. The authors assessed the survival of patients with a first generalised tonic-clonic seizure, randomised to immediate treatment (treated) versus treatment only in the event of seizure recurrence (untreated), over a 20-year period. METHODS: The authors followed 419 patients. The median follow-up was 19.7 years (range 0.2-21.5) for a total of 7867 person-years. RESULTS: 40 persons (9.6%) died during follow-up, 19 (8.9%) treated and 21 (10.3.%) untreated. The probability of surviving was 100% at 1 year, 97% (95% CI 95% to 99%) at 5 years, 94% (91-97) at 10 years and 91% (87-95) at 20 years in treated patients and 100%, 98% (95-100), 97% (94-99) and 89% (85-94), respectively, in untreated patients (p=0.7). After adjustment for treatment of first seizure and putative risk factors (gender, age, seizure type, previous uncertain seizures, family history of seizures, pre-, peri- and postnatal risk factors, remote aetiological factors for epilepsy, abnormal neurological examination, CT or MRI abnormalities, EEG abnormalities and acute treatment), only the presence of aetiological factors for epilepsy predicted a higher mortality (HR 3.4, 95% CI 2.5 to 4.3%; p
- Published
- 2011