Seizure natural history, complications and prognosis: Difference between revisions
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===Complications=== | ===Complications=== | ||
Some [[complications]] that have been suggested in seizure include:<ref name="pmid30948624">{{cite journal| author=Foster E, Carney P, Liew D, Ademi Z, O'Brien T, Kwan P| title=First seizure presentations in adults: beyond assessment and treatment. | journal=J Neurol Neurosurg Psychiatry | year= 2019 | volume= 90 | issue= 9 | pages= 1039-1045 | pmid=30948624 | doi=10.1136/jnnp-2018-320215 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30948624 }} </ref> | |||
* Accidents and [[injuries]] | |||
**[ | **Mostly [[cranial]] soft tissue [[contusions]] or [[lacerations]] | ||
**[ | * Lifestyle and [[psychosocial]] impact | ||
**[ | ** Financial, social, and relationship problems such as driving, work-related activities, reduced productivity, stigma in society | ||
* [[Comorbidities]] | |||
** [[Medical]]: [[stroke]], [[ischaemic heart disease]], [[cancer]], [[migraine]], [[vertigo]], and [[sleep disorders]] | |||
** [[Psychiatric]]: [[depression]] and anxiety | |||
** [[Neurodegenerative]] diseases: [[dementia]] and [[Alzheimer disease |Alzheimer disease (AD)]] | |||
* [[Death]] | |||
===Prognosis=== | ===Prognosis=== | ||
Revision as of 14:17, 30 October 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]
Natural History
Seizures can cause involuntary changes in body movement or function, sensation, awareness, or behavior. A seizure can last from a few seconds to status epilepticus, a continuous seizure that will not stop without intervention. Seizure is often associated with a sudden and involuntary contraction of a group of muscles. However, a seizure can also be as subtle as marching numbness of a part of the body, a brief loss of memory, sparkling or flashes, sensing an unpleasant odor, a strange epigastric sensation or a sensation of fear. Therefore seizures are typically classified as motor, sensory, autonomic, emotional or cognitive.
In some cases, the full onset of a seizure event is preceded by some of the sensations described above. These sensations can serve as a warning to the sufferer that a full tonic-clonic seizure is about to occur. These "warning sensations" are cumulatively called an aura.[1]
Overview
The recurrence rate of seizure within 2 years is 35% to 40% in patients with a first-time unprovoked seizure. Status epilepticus occurs in about 6%-7% of the patients with seizure in the emergency department (ED). The overall mortality rate of status epilepticus is approximately 22% (3% in pediatric patients to 26% in adults). Simple febrile seizures are considered normal in childhood and the prognosis is generally excellent. The recurrence rate is about 12% in children that have their first febrile seizure in infancy and about 50% in those who have their first febrile seizure later.
Natural History, Complications, and Prognosis
Natural History
- The recurrence rate of seizure within 2 years is 35% to 40% in patients with a first-time unprovoked seizure.[2]
- In a cohort study that followed patients for 10 years after an acute symptomatic seizure in an ED visit (excluding children with febrile seizure), the risk of recurrence was 13% in those patients who had an unprovoked seizure and 41% in those who had acute symptomatic status epilepticus.[3]
- Status epilepticus occurs in about 6%-7% of the patients with seizure in the emergency department (ED).[4][5][6]
Complications
Some complications that have been suggested in seizure include:[7]
- Accidents and injuries
- Mostly cranial soft tissue contusions or lacerations
- Lifestyle and psychosocial impact
- Financial, social, and relationship problems such as driving, work-related activities, reduced productivity, stigma in society
- Comorbidities
- Medical: stroke, ischaemic heart disease, cancer, migraine, vertigo, and sleep disorders
- Psychiatric: depression and anxiety
- Neurodegenerative diseases: dementia and Alzheimer disease (AD)
- Death
Prognosis
- Simple febrile seizures are considered normal in childhood and the prognosis is generally excellent.
- The recurrence rate is about 12% in children that have their first febrile seizure in infancy and about 50% in those who have their first febrile seizure later.[8][9]
- The risk of epilepsy is the same as children without any history of febrile seizure.
- Complex febrile seizures increase the risk for epilepsy, and but do not increase the risk for a future simple febrile seizure.[10]
- The overall mortality rate of status epilepticus is approximately 22% (3% in pediatric patients to 26% in adults).[11]
References
- ↑ "Auras | epilepsy.com". Retrieved 2013-03-04.
- ↑ Berg AT, Testa FM, Levy SR, Shinnar S (1996). "The epidemiology of epilepsy. Past, present, and future". Neurol Clin. 14 (2): 383–98. doi:10.1016/s0733-8619(05)70263-2. PMID 8827178.
- ↑ Hesdorffer DC, Logroscino G, Cascino G, Annegers JF, Hauser WA (1998). "Risk of unprovoked seizure after acute symptomatic seizure: effect of status epilepticus". Ann Neurol. 44 (6): 908–12. doi:10.1002/ana.410440609. PMID 9851435.
- ↑ Huff JS, Morris DL, Kothari RU, Gibbs MA, Emergency Medicine Seizure Study Group (2001). "Emergency department management of patients with seizures: a multicenter study". Acad Emerg Med. 8 (6): 622–8. doi:10.1111/j.1553-2712.2001.tb00175.x. PMID 11388937.
- ↑ Krumholz A, Grufferman S, Orr ST, Stern BJ (1989). "Seizures and seizure care in an emergency department". Epilepsia. 30 (2): 175–81. doi:10.1111/j.1528-1157.1989.tb05451.x. PMID 2924743.
- ↑ Brinar V, Bozicević D, Zurak N, Gubarev N, Djaković V (1991). "Epileptic seizures as a symptom of various neurological diseases". Neurol Croat. 40 (2): 93–101. PMID 1883923.
- ↑ Foster E, Carney P, Liew D, Ademi Z, O'Brien T, Kwan P (2019). "First seizure presentations in adults: beyond assessment and treatment". J Neurol Neurosurg Psychiatry. 90 (9): 1039–1045. doi:10.1136/jnnp-2018-320215. PMID 30948624.
- ↑ Kenney RD, Taylor JA (1992). "Absence of serum chemistry abnormalities in pediatric patients presenting with seizures". Pediatr Emerg Care. 8 (2): 65–6. doi:10.1097/00006565-199204000-00001. PMID 1603702.
- ↑ Walton DM, Thomas DC, Aly HZ, Short BL (2000). "Morbid hypocalcemia associated with phosphate enema in a six-week-old infant". Pediatrics. 106 (3): E37. doi:10.1542/peds.106.3.e37. PMID 10969121.
- ↑ Berg AT (1992). "Febrile seizures and epilepsy: the contributions of epidemiology". Paediatr Perinat Epidemiol. 6 (2): 145–52. doi:10.1111/j.1365-3016.1992.tb00756.x. PMID 1584717.
- ↑ DeLorenzo RJ, Hauser WA, Towne AR, Boggs JG, Pellock JM, Penberthy L; et al. (1996). "A prospective, population-based epidemiologic study of status epilepticus in Richmond, Virginia". Neurology. 46 (4): 1029–35. doi:10.1212/wnl.46.4.1029. PMID 8780085.