Abstract
Following the occurrence of an unprovoked first seizure in adults, the risk of seizure recurrence is greatest within the next 2 years. Although immediate antiepileptic drug therapy will not improve the longer-term (>3 years) prognosis for seizure remission, it will reduce the risk of seizure recurrence over the first 2 years. An individualized treatment plan that considers the likelihood of seizure recurrence versus the risks of adverse events should be adopted.
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References
Hauser WA, Beghi E. First seizure definitions and worldwide incidence and mortality. Epilepsia. 2008;49(Suppl 1):8–12.
Gloss DS, Krumholz A. Managing an unprovoked first seizure in adults. CNS Drugs. 2016;30(3):179–83.
Krumholz A, Shinnar S, French J, et al. Evidence-based guideline: management of an unprovoked first seizure in adults. Report of the Guideline Development Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2015;85(17):1526–7.
Krumholz A, Wiebe S, Gronseth G, et al. Practice parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2007;69(21):1996–2007.
Firkin AL, Marco DJ, Saya S, et al. Mind the gap: multiple events and lengthy delays before presentation with a “first seizure”. Epilepsia. 2015;56(10):1534–41.
Hauser WA, Rich SS, Lee JR, et al. Risk of recurrent seizures after two unprovoked seizures. N Engl J Med. 1998;338(7):429–34.
Randomized clinical trial on the efficacy of antiepileptic drugs in reducing the risk of relapse after a first unprovoked tonic-clonic seizure. First Seizure Trial Group (FIR.S.T. Group) Neurology. 1993;43(3 Pt 1):478–83.
Marson A, Jacoby A, Johnson A, et al. Immediate versus deferred antiepileptic drug treatment for early epilepsy and single seizures: a randomized controlled trial. Lancet. 2005;365(9476):2007–13.
Chandra B. First seizure in adults: to treat or not to treat. Clin Neurol Neurosurg. 1992;94(Suppl):S61–3.
Gilad R, Lampl Y, Gabbay U, et al. Early treatment of a single generalized tonic-clonic seizure to prevent recurrence. Arch Neurol. 1996;53(11):1149–52.
Ruggles KH, Haessly SM, Berg RL. Prospective study of seizures in the elderly in the Marshfield Epidemiologic Study Area (MESA). Epilepsia. 2001;42Z(12):1594–9.
Jacoby A, Gamble C, Doughty J, et al. Quality of life outcomes of immediate or delayed treatment of early epilepsy and single seizures. Neurology. 2007;68(15):1188–96.
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The article was adapted from CNS Drugs 2016;30(3):179–83 [2] by salaried employees of Adis/Springer and was not supported by any external funding.
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Adis Medical Writers. When managing an unprovoked first seizure in adults, carefully consider the benefits and risks of initiating antiepileptic treatment. Drugs Ther Perspect 32, 434–436 (2016). https://doi.org/10.1007/s40267-016-0323-4
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DOI: https://doi.org/10.1007/s40267-016-0323-4