Risk of recurrence after a first unprovoked seizure in children
Objectives: This study aimed to evaluate the first episode of unprovoked epileptic seizure in children and assess recurrence risk factors. Methods: This was a retrospective observational study, based on the analysis of medical records of patients admitted between 2003 and 2014, with first epileptic...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2017-05-01
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| Series: | Jornal de Pediatria |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0021755716301218 |
| _version_ | 1817988148924252160 |
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| author | Catarina Maia Ana Raquel Moreira Tânia Lopes Cecília Martins |
| author_facet | Catarina Maia Ana Raquel Moreira Tânia Lopes Cecília Martins |
| author_sort | Catarina Maia |
| collection | DOAJ |
| description | Objectives: This study aimed to evaluate the first episode of unprovoked epileptic seizure in children and assess recurrence risk factors. Methods: This was a retrospective observational study, based on the analysis of medical records of patients admitted between 2003 and 2014, with first epileptic seizure, at the pediatric service of a secondary hospital. The data were analyzed using the SPSS 20.0 program. Results: Of the 103 patients, 52.4% were boys. The median age at the first seizure was 59 (1–211) months. About 93% of children were submitted to an electroencephalogram at the first episode and 47% underwent neuroimaging assessment. Treatment with an antiepileptic drug was started in 46% of patients. The recurrence rate was 38% and of these, 80% had the second seizure within six months after the first event. Of the assessed risk factors, there was a statistically significant association between seizure during sleep and recurrence (p = 0.004), and between remote symptomatic etiology seizure and occurrence of new seizure (p = 0.02). The presence of electroencephalogram abnormalities was also associated with the occurrence of new seizures (p = 0.021). No association was found between age, duration of the seizure, and family history of epilepsy with increased risk of recurrence. Conclusions: Most children with a first unprovoked epileptic seizure had no recurrences. The risk of recurrence was higher in patients with seizure occurring during sleep or remote symptomatic ones and those with abnormal electroencephalogram results. Resumo: Objetivos: Este trabalho teve como objetivos estudar o primeiro episódio de crise epilética não provocada em idade pediátrica e avaliar os fatores de risco de recorrência. Métodos: Estudo observacional retrospectivo, baseado na análise dos processos clínicos dos pacientes internados entre 2003 e 2014, num serviço de pediatria de um hospital de nível 2, com primeira crise epilética. Os dados foram trabalhados com o programa SPSS Statistics 20.0. Resultados: Dos 103 pacientes, 52,4% eram meninos. A mediana da idade da primeira crise foi 59 (1-211) meses. Cerca de 93% das crianças realizaram eletroencefalograma no primeiro episódio e 47% realizaram neuroimagem. O tratamento com fármaco antiepilético foi instituído em 46% dos pacientes. A taxa de recorrência foi 38% e, destes, 80% tiveram a segunda crise nos 6 meses seguintes após o primeiro evento. Dos fatores de risco estudados verificou-se uma relação estatisticamente significativa entre a crise durante o sono e a recorrência (p = 0,004), assim como entre as crises de etiologia sintomática remota e a ocorrência de novas crises (p = 0,02). A presença de anormalidades no eletroencefalograma também esteve associada à ocorrência de novas crises (p = 0,021). Não se encontrou relação entre idade, duração da crise e história familiar de epilepsia com risco aumentado de recorrência. Conclusões: A maioria das crianças com uma primeira crise epilética não provocada não teve recorrências. O risco de recorrência foi superior nos pacientes com crise durante o sono ou crise sintomática remota e naqueles com eletroencefalograma alterado. Keywords: Seizures, First unprovoked seizure, Recurrence, Child, Palavras-chave: Convulsão, Primeira crise não provocada, Recorrência, Criança |
| first_indexed | 2024-04-14T00:30:40Z |
| format | Article |
| id | doaj.art-db22102b14fb4c98bf057e40f077b668 |
| institution | Directory Open Access Journal |
| issn | 0021-7557 |
| language | English |
| last_indexed | 2024-04-14T00:30:40Z |
| publishDate | 2017-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Jornal de Pediatria |
| spelling | doaj.art-db22102b14fb4c98bf057e40f077b6682022-12-22T02:22:33ZengElsevierJornal de Pediatria0021-75572017-05-01933281286Risk of recurrence after a first unprovoked seizure in childrenCatarina Maia0Ana Raquel Moreira1Tânia Lopes2Cecília Martins3Centro Hospitalar de Vila Nova de Gaia/Espinho, Serviço de Pediatria, Vila Nova de Gaia, Portugal; Corresponding author.Centro Hospitalar do Médio Ave, Serviço de Pediatria, Famalicão, PortugalCentro Hospitalar do Médio Ave, Serviço de Pediatria, Famalicão, PortugalCentro Hospitalar do Médio Ave, Serviço de Pediatria, Famalicão, PortugalObjectives: This study aimed to evaluate the first episode of unprovoked epileptic seizure in children and assess recurrence risk factors. Methods: This was a retrospective observational study, based on the analysis of medical records of patients admitted between 2003 and 2014, with first epileptic seizure, at the pediatric service of a secondary hospital. The data were analyzed using the SPSS 20.0 program. Results: Of the 103 patients, 52.4% were boys. The median age at the first seizure was 59 (1–211) months. About 93% of children were submitted to an electroencephalogram at the first episode and 47% underwent neuroimaging assessment. Treatment with an antiepileptic drug was started in 46% of patients. The recurrence rate was 38% and of these, 80% had the second seizure within six months after the first event. Of the assessed risk factors, there was a statistically significant association between seizure during sleep and recurrence (p = 0.004), and between remote symptomatic etiology seizure and occurrence of new seizure (p = 0.02). The presence of electroencephalogram abnormalities was also associated with the occurrence of new seizures (p = 0.021). No association was found between age, duration of the seizure, and family history of epilepsy with increased risk of recurrence. Conclusions: Most children with a first unprovoked epileptic seizure had no recurrences. The risk of recurrence was higher in patients with seizure occurring during sleep or remote symptomatic ones and those with abnormal electroencephalogram results. Resumo: Objetivos: Este trabalho teve como objetivos estudar o primeiro episódio de crise epilética não provocada em idade pediátrica e avaliar os fatores de risco de recorrência. Métodos: Estudo observacional retrospectivo, baseado na análise dos processos clínicos dos pacientes internados entre 2003 e 2014, num serviço de pediatria de um hospital de nível 2, com primeira crise epilética. Os dados foram trabalhados com o programa SPSS Statistics 20.0. Resultados: Dos 103 pacientes, 52,4% eram meninos. A mediana da idade da primeira crise foi 59 (1-211) meses. Cerca de 93% das crianças realizaram eletroencefalograma no primeiro episódio e 47% realizaram neuroimagem. O tratamento com fármaco antiepilético foi instituído em 46% dos pacientes. A taxa de recorrência foi 38% e, destes, 80% tiveram a segunda crise nos 6 meses seguintes após o primeiro evento. Dos fatores de risco estudados verificou-se uma relação estatisticamente significativa entre a crise durante o sono e a recorrência (p = 0,004), assim como entre as crises de etiologia sintomática remota e a ocorrência de novas crises (p = 0,02). A presença de anormalidades no eletroencefalograma também esteve associada à ocorrência de novas crises (p = 0,021). Não se encontrou relação entre idade, duração da crise e história familiar de epilepsia com risco aumentado de recorrência. Conclusões: A maioria das crianças com uma primeira crise epilética não provocada não teve recorrências. O risco de recorrência foi superior nos pacientes com crise durante o sono ou crise sintomática remota e naqueles com eletroencefalograma alterado. Keywords: Seizures, First unprovoked seizure, Recurrence, Child, Palavras-chave: Convulsão, Primeira crise não provocada, Recorrência, Criançahttp://www.sciencedirect.com/science/article/pii/S0021755716301218 |
| spellingShingle | Catarina Maia Ana Raquel Moreira Tânia Lopes Cecília Martins Risk of recurrence after a first unprovoked seizure in children Jornal de Pediatria |
| title | Risk of recurrence after a first unprovoked seizure in children |
| title_full | Risk of recurrence after a first unprovoked seizure in children |
| title_fullStr | Risk of recurrence after a first unprovoked seizure in children |
| title_full_unstemmed | Risk of recurrence after a first unprovoked seizure in children |
| title_short | Risk of recurrence after a first unprovoked seizure in children |
| title_sort | risk of recurrence after a first unprovoked seizure in children |
| url | http://www.sciencedirect.com/science/article/pii/S0021755716301218 |
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