Last modified: 2014-04-03
Abstract
INTRODUCTION: Epilepsy risk factors in children may be of interest in the field of childhood epileptology [1,2,3].
OBJECTIVE: The aim was to compare clinical, EEG and neuroimaging data of patients with epilepsy and first unprovoked seizure and reveal epilepsy risk factors.
MATERIAL AND METHODS: In a prospective study 315 patients with epilepsy and 42 with first unprovoked seizure, aged from 2 months to 18 years, were included. We analyzed characteristics of the first seizure, perinatal history, family history of seizures, neurological examination. The patients underwent EEG and neuroimaging [Computed Tomography (CT) and/or Magnetic Resonance Imaging (MRI)]. Children were followed for 3 years from the time of first seizure.
RESULTS: The risk factors for epilepsy were early seizure onset (before 6 month) (p<0,0001), family history of seizures of first range relationship (p=0,0466), neurological abnormality (including psychomotor retardation) (p=0,0024), atrophic change defined by neuroimaging (χ2=11,04; p=0,0009). Using general regression analyses we revealed that early seizure onset (p<0,0001) and neurological abnormality (p<0,05) were the only variables significantly associated with recurrence and were cumulative risk factors for epilepsy in children comparing with first unprovoked seizure group.
CONCLUSIONS: This study suggested that early seizure onset and neurological abnormality may have an important diagnostic value in the prognosis of epileptic seizure recurrence in children.These results might help in developing of diagnostic protocol in epilepsy in children.
Keywords
References
1.Arthur TM, deGrauw TJ, Johnson CS, Perkins SM, Kalnin A, Austin JK, Dunn DW. Seizure recurrence risk following a first seizure in neurologically normal children / Epilepsia. 2008 Nov;49(11):1950-4.
2.Johnson RE, Nolan MA. Evaluation of first unprovoked seizures in children by general paediatricians in New Zealand / J Paediatr Child Health. 2006 Nov;42(11):721-5.
3.Hirtz D, Berg A, Bettis D, Camfield C, Camfield P, Crumrine P, Gaillard WD, Schneider S, Shinnar S; Quality Standards Subcommittee of the American Academy of Neurology; Practice Committee of the Child Neurology Society. Practice parameter: treatment of the child with a first unprovoked seizure: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society / Neurology. 2003 Jan 28;60(2):166-75.