Is a first acute symptomatic seizure epilepsy? Mortality and risk for recurrent seizure

Summary Purpose:  To compare mortality and subsequent unprovoked seizure risk in a population‐based study of acute symptomatic seizure and first unprovoked seizure due to static brain lesions. Methods:  We ascertained all first episodes of acute symptomatic seizure and unprovoked seizure due to cent...

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Vydáno v:Epilepsia (Copenhagen) Ročník 50; číslo 5; s. 1102 - 1108
Hlavní autoři: Hesdorffer, Dale C., Benn, Emma K. T., Cascino, Gregory D., Hauser, W. Allen
Médium: Journal Article
Jazyk:angličtina
Vydáno: Oxford, UK Blackwell Publishing Ltd 01.05.2009
Wiley-Blackwell
Témata:
Acute Disease
Acute symptomatic seizure
Adolescent
Adult
Age of Onset
Aged
Anticonvulsants. Antiepileptics. Antiparkinson agents
Biological and medical sciences
Central Nervous System Diseases - complications
Chi-Square Distribution
Child
Child, Preschool
Epidemiology
Epilepsy
Epilepsy - epidemiology
Epilepsy - etiology
Epilepsy - mortality
Female
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Infant
Infant, Newborn
Male
Medical sciences
Middle Aged
Minnesota - epidemiology
Mortality
Nervous system (semeiology, syndromes)
Neurology
Neuropharmacology
Pharmacology. Drug treatments
Recurrence
Risk Factors
Seizure recurrence
Seizures - classification
Seizures - epidemiology
Seizures - etiology
Seizures - mortality
Time Factors
Young Adult
Minnesota
Recurrence
Nervous system diseases
Epilepsy
Mortality
Recurrent
Epidemiology
Cerebral disorder
Seizure recurrence
Convulsion
Acute symptomatic seizure
Central nervous system disease
Risk factor
Neurological disorder
ISSN:0013-9580, 1528-1167, 1528-1167
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Shrnutí:Summary Purpose:  To compare mortality and subsequent unprovoked seizure risk in a population‐based study of acute symptomatic seizure and first unprovoked seizure due to static brain lesions. Methods:  We ascertained all first episodes of acute symptomatic seizure and unprovoked seizure due to central nervous system (CNS) infection, stroke, and traumatic brain injury (TBI). Subjects were residents of Rochester, Minnesota, identified through the Rochester Epidemiology Project’s records‐linkage system between 1/1/55 and 12/31/84. Information was collected on age, gender, seizure type, etiology, status epilepticus (SE), 30‐day and 10‐year mortality, and subsequent episodes of unprovoked seizure. Results:  Two hundred sixty‐two individuals experienced a first acute symptomatic seizure and 148 individuals experienced a first unprovoked seizure, all due to static brain lesions. Individuals with a first acute symptomatic seizure were 8.9 times more likely to die within 30 days compared to those with a first unprovoked seizure [95% confidence intervals (CI) = 3.5–22.5] after adjustment for age, gender, and SE. Among 30‐day survivors, the risk of 10‐year mortality did not differ. Over the 10‐year period, individuals with a first acute symptomatic seizure were 80% less likely to experience a subsequent unprovoked seizure compared with individuals with a first unprovoked seizure [adjusted rate ratio (RR) = 0.2, 95% CI = 0.2–0.4]. Discussion:  The prognosis of first acute symptomatic seizures differs from that of first unprovoked seizure when the etiology is stroke, TBI, and CNS infection. Acute symptomatic seizures have a higher early mortality and a lower risk for subsequent unprovoked seizure. These differences argue against the inclusion of acute symptomatic seizures as epilepsy.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0013-9580
1528-1167
1528-1167
DOI:10.1111/j.1528-1167.2008.01945.x