Recurrence Risk after a First Seizure

In an unselected sample of the population, isolated seizures occur in 20-40% of people with one or more seizures. It is methodologically extremely difficult to investigate the recurrence risk after an initial epileptic seizure. Estimates in the literature range between 27 and 71%, depending on inclusion criteria, duration of follow-up, and whether or not patients are treated after a first seizure. The most important source of error has been the exclusion of patients with early recurrences of seizures before presentation. The longer the interval between first seizure and inclusion into the study, the lower the recurrence rate.

The recurrence risk within 24 months of a first seizure calculated from a meta-analysis of 14 studies was 42%, with a higher risk in the group of patients with symptomatic seizures and pathological EEG findings (65%) compared to those patients with idiopathic seizures and a normal EEG (24%).

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