Seizure natural history, complications and prognosis: Difference between revisions
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===Natural History=== | ===Natural History=== | ||
*The recurrence rate of seizure within 2 years is 35% to 40% in patients with a first-time unprovoked seizure.<ref name="pmid8827178">{{cite journal| author=Berg AT, Testa FM, Levy SR, Shinnar S| title=The epidemiology of epilepsy. Past, present, and future. | journal=Neurol Clin | year= 1996 | volume= 14 | issue= 2 | pages= 383-98 | pmid=8827178 | doi=10.1016/s0733-8619(05)70263-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8827178 }} </ref> | *The recurrence rate of seizure within 2 years is 35% to 40% in [[patients]] with a first-time unprovoked seizure.<ref name="pmid8827178">{{cite journal| author=Berg AT, Testa FM, Levy SR, Shinnar S| title=The epidemiology of epilepsy. Past, present, and future. | journal=Neurol Clin | year= 1996 | volume= 14 | issue= 2 | pages= 383-98 | pmid=8827178 | doi=10.1016/s0733-8619(05)70263-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8827178 }} </ref> | ||
*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]].<ref name="pmid9851435">{{cite journal| author=Hesdorffer DC, Logroscino G, Cascino G, Annegers JF, Hauser WA| title=Risk of unprovoked seizure after acute symptomatic seizure: effect of status epilepticus. | journal=Ann Neurol | year= 1998 | volume= 44 | issue= 6 | pages= 908-12 | pmid=9851435 | doi=10.1002/ana.410440609 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9851435 }} </ref> | *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]].<ref name="pmid9851435">{{cite journal| author=Hesdorffer DC, Logroscino G, Cascino G, Annegers JF, Hauser WA| title=Risk of unprovoked seizure after acute symptomatic seizure: effect of status epilepticus. | journal=Ann Neurol | year= 1998 | volume= 44 | issue= 6 | pages= 908-12 | pmid=9851435 | doi=10.1002/ana.410440609 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9851435 }} </ref> | ||
*[[Status epilepticus]] occurs in about 6%-7% of the patients with seizure in the [[emergency department|emergency department (ED)]].<ref name="pmid11388937">{{cite journal| author=Huff JS, Morris DL, Kothari RU, Gibbs MA, Emergency Medicine Seizure Study Group| title=Emergency department management of patients with seizures: a multicenter study. | journal=Acad Emerg Med | year= 2001 | volume= 8 | issue= 6 | pages= 622-8 | pmid=11388937 | doi=10.1111/j.1553-2712.2001.tb00175.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11388937 }} </ref><ref name="pmid2924743">{{cite journal| author=Krumholz A, Grufferman S, Orr ST, Stern BJ| title=Seizures and seizure care in an emergency department. | journal=Epilepsia | year= 1989 | volume= 30 | issue= 2 | pages= 175-81 | pmid=2924743 | doi=10.1111/j.1528-1157.1989.tb05451.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2924743 }} </ref><ref name="pmid1883923">{{cite journal| author=Brinar V, Bozicević D, Zurak N, Gubarev N, Djaković V| title=Epileptic seizures as a symptom of various neurological diseases. | journal=Neurol Croat | year= 1991 | volume= 40 | issue= 2 | pages= 93-101 | pmid=1883923 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1883923 }} </ref> | *[[Status epilepticus]] occurs in about 6%-7% of the patients with seizure in the [[emergency department|emergency department (ED)]].<ref name="pmid11388937">{{cite journal| author=Huff JS, Morris DL, Kothari RU, Gibbs MA, Emergency Medicine Seizure Study Group| title=Emergency department management of patients with seizures: a multicenter study. | journal=Acad Emerg Med | year= 2001 | volume= 8 | issue= 6 | pages= 622-8 | pmid=11388937 | doi=10.1111/j.1553-2712.2001.tb00175.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11388937 }} </ref><ref name="pmid2924743">{{cite journal| author=Krumholz A, Grufferman S, Orr ST, Stern BJ| title=Seizures and seizure care in an emergency department. | journal=Epilepsia | year= 1989 | volume= 30 | issue= 2 | pages= 175-81 | pmid=2924743 | doi=10.1111/j.1528-1157.1989.tb05451.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2924743 }} </ref><ref name="pmid1883923">{{cite journal| author=Brinar V, Bozicević D, Zurak N, Gubarev N, Djaković V| title=Epileptic seizures as a symptom of various neurological diseases. | journal=Neurol Croat | year= 1991 | volume= 40 | issue= 2 | pages= 93-101 | pmid=1883923 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1883923 }} </ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]
Overview
The recurrence rate of seizure within two 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.[1]
- 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.[2]
- Status epilepticus occurs in about 6%-7% of the patients with seizure in the emergency department (ED).[3][4][5]
Complications
Some complications that have been suggested in seizure include:[6]
- 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.[7][8]
- 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.[9]
- The overall mortality rate of status epilepticus is approximately 22% (3% in pediatric patients to 26% in adults).[10]
References
- ↑ 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.