Risk factors affecting the first unprovoked seizure recurrence in childhood: A retrospective cohort study

Zeynep Beyza Kuşku, Department of Paediatrics, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
Arzu Ekici, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Pediatrics, Division of Neurology -Bursa, Turkey

Introduction and Objectives: The decision of antiepileptic drug (AED) prescription following the first unprovoked seizure should be made considering the side-effects of the drug and the recurrence risk of seizure. The aim of this study was to define the seizure recurrence rate and risk factors among children with unprovoked seizures for the first time. Methods: A total of 102 paediatric patients who were followed up for a minimum of two years after their admission to the emergency department with first unprovoked seizure were evaluated retrospectively. Results: A total of 102 patients were included in this study. The vast majority of the patients were awake during the seizure (80.4%) and had a generalized type of seizure (91.2%). The median duration of patient follow-up was 36 months. The seizure recurred in 22 (21.6%) of the patients. The median time of seizure recurrence was three months (min-max: 2 days-3 years). Seizure recurrence was significantly higher in patients who had their first seizure between 7 and 11 years of age, during sleep (p = 0.009, p = 0.025, respectively). Seizure recurrence was higher among patients with a seizure duration longer than 5 minutes (p = 0.008). Conclusion: Due to the significant risk of seizure recurrence, patients with unprovoked seizures who experience seizures in sleep and last longer than 5 minutes should undergo a more thorough evaluation before considering antiepileptic drugs.

Keywords: Antiepileptic drug. Children. Recurrence. Unprovoked seizure.