PROGNOSIS OF CHILDREN WITH A FIRST UNPROVOKED SEIZURE

Project: Research project

Project Details

Description

Knowledge of the natural history of children and adolescents
following a first unprovoked seizure and the risk factors for
recurrence is a necessary prerequisite for making rational
decisions regarding who should be treated with antiepileptic
drugs. A better understanding of the early time course of
epilepsy in those children who go on to recur is also needed to
understand the evolution of epilepsy in those children who go on
to recur is also needed to understand the evolution of epilepsy and
the factors that cause some patients to develop intractable
seizures and some to go into remission. Of particular interest are
the outcomes and recurrence risks of the subgroup of children and
adolescents who present with status epilepticus as their first
unprovoked seizure. Also of interest are children with abnormal
electroencephalograms or prior neurological handicap who present
with a single seizure. In an ongoing prospective study we have recruited a cohort of 180
children and adolescents who presented with a first unprovoked
seizure and have followed them for a mean of one year. Based on
our preliminary results the following hypotheses are proposed. 1:
The majority of children with a first unprovoked seizure will not
have recurrent seizures. 2: Predictive factors including the
etiology of seizures (idiopathic vs remote symptomatic) and the
electroencephalogram allow identification of subgroups with a
very low and a high risk of recurrence. 3: The outcomes of
children who present with status epilepticus as their first
unprovoked seizure is not significantly different than those who
present with a brief seizure. 4: The majority of children who have
recurrent seizures will be readily controlled with a single
antiepileptic drug and go into remission. The current study proposed to recruit a cohort of 300-350 children
and adolescents with a first unprovoked seizure and follow them
for a mean of 5 years. Results will be analyzed using Kaplan-
Meier techniques which take into account the variable length of
follow-up inherent in these studies. These numbers are needed to
answer the above hypotheses with sufficient power and provide a
sufficiently long follow-up period to ensure the validity of the
outcomes. Less than 10% of children with a first seizure are
treated with long term medications at our institution. Therefore
these results will reflect the true course of the disorder.
StatusFinished
Effective start/end date4/1/883/31/05

Funding

  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $194,058.00
  • National Institutes of Health
  • National Institutes of Health: $149,937.00
  • National Institutes of Health: $7,500.00
  • National Institutes of Health
  • National Institutes of Health: $304,219.00
  • National Institutes of Health
  • National Institutes of Health: $175,911.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $341,675.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $331,725.00

ASJC

  • Medicine(all)
  • Neuroscience(all)

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