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Russian Journal of Child Neurology

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Management of patients with single and rare epileptic seizures

https://doi.org/10.17650/2073-8803-2020-15-2-12-16

Abstract

Objective: to study the structure of the disease and develop tactics of treatment of patients with single and rare epileptic seizures.
Materials and methods. 1200 patients with epilepsy were examined, 103 patients were identified who had no more than 3 seizures throughout their life. Study included evaluation of anamnesis, clinical and neurological examination, routine electroencephalography and/or videoelectroencephalographic monitoring, magnetic resonance imaging of the brain.
Results. Relapse of seizures in individuals with a history of follow-up occurred in 32 % of cases; epileptogenic changes in magnetic resonance image and, especially, anatomical and electro-clinical correlation of the epilepsy focus were associated with the risk of relapse.
Conclusions. The decision on drug therapy after the first unprovoked seizure should be based on the ratio of the risk of repeated seizures and the risk of side effects. This solution should be individual and take into account not only medical problems, but also the preferences of the patient and his family members.

About the Author

A. S. Kotov
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
61/2 Shchepkina St., Moscow 129110


References

1. Annegers J.F., Shirts S.B., Hauser W.A., Kurland L.T. Risk of recurrence after an initial unprovoked seizure. Epilepsia 1986;27(1):43–50. DOI: 10.1111/j.1528-1157.1986.tb03499.x.

2. Beghi E., Ciccone A. Recurrence after a first unprovoked seizure. Is it still a controversial issue? First Seizure Trial Group (first). Seizure 1993;2(1):5–10. DOI: 10.1016/s1059-1311(05)80096-2.

3. Berg A.T., Shinnar S. The contributions of epidemiology to the understanding of childhood seizures and epilepsy. J Child Neurol 1994;9(Suppl 2):19–26.

4. Berg A.T., Shinnar S. The risk of seizure recurrence following a first unprovoked seizure: a quantitative review. Neurology 1991;41(7):965–72. DOI: 10.1212/wnl.41.7.965.

5. Chandra B. First seizure in adults: to treat or not to treat. Clin Neurol Neurosurg 1992;94(Suppl):S61–3. DOI: 10.1016/0303-8467(92)90024-w.

6. Das C.P., Sawhney I.M., Lal V., Prabhakar S. Risk of recurrence of seizures following single unprovoked idiopathic seizure. Neurol India 2000;48(4):357–60.

7. Elwes R.D., Johnson A.L., Reynolds E.H. The course of untreated epilepsy. BMJ 1988 15;297(6654):948–50. DOI: 10.1136/bmj.297.6654.948.

8. Gowers W.R. Epilepsy and other chronic convulsive diseases. London: Churchill, 1881.

9. Hart Y.M., Sander J.W., Johnson A.L., Shorvon S.D. National General Practice Study of Epilepsy: recurrence after a first seizure. Lancet 1990;336(8726):1271–4. DOI: 10.1016/0140-6736(90)92960-p.

10. Jallon P. Prognosis of epilepsies. Montrouge: John Libbey Eurotext, 2003.

11. 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. DOI: 10.1212/01.wnl.0000473351.32413.7c.

12. 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. DOI: 10.1016/S0140-6736(05)66694-9.

13. Randomized clinical trial on the efficacy of antiepileptic drugs in reducing the risk of relapse after a first unprovoked tonicclonic seizure. First Seizure Trial Group (FIR.S.T. Group). Neurology 1993;43(3 Pt 1):478–83. DOI: 10.1212/wnl.43.3_part_1.478.

14. Reynolds E.H. Early treatment and prognosis of epilepsy. Epilepsia 1987;28(2):97–106. DOI: 10.1111/j.1528-1157.1987.tb03633.x.

15. Reynolds E.H. The process of epilepsy: is kindling relevant? In: The Clinical Relevance of Kindling. Eds.: G. Bowling, M.R. Trimble. Chichester: John Wiley & Sons, 1989. Pp. 149–160.

16. Rodin E.A. The prognosis of patients with epilepsy. Springfield: Charles C. Thomas, 1968.

17. Sander J.W. Some aspects of prognosis in the epilepsies: a review. Epilepsia 1993;34(6):1007–16. DOI: 10.1111/j.1528-1157.1993.tb02126.x.

18. Shinnar S., Berg A.T. Does antiepileptic drug therapy prevent the development of “chronic” epilepsy? Epilepsia 1996;37(8):701–8. DOI: 10.1111/j.1528-1157.1996.tb00639.x.


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For citations:


Kotov A.S. Management of patients with single and rare epileptic seizures. Russian Journal of Child Neurology. 2020;15(2):12-16. (In Russ.) https://doi.org/10.17650/2073-8803-2020-15-2-12-16

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ISSN 2073-8803 (Print)
ISSN 2412-9178 (Online)