Management of patients with single and rare epileptic seizures

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.