THE RISK OF SEIZURE RECURRENCE IN CHILDREN AND ADOLESCEN

Project: Research project

Project Details

Description

Epilepsy is a common disorder. At present there is insufficient data on
the natural history and prognosis of convulsive disorders. The present
research plan is designed to prospectively investigate the risks of seizure
recurrence in twp settings: 1) Following a single unprovoked seizure 2)
Following discontinuation of anticonvulsant medications in patients with
two or more seizures who have been seizure free for two or more years. In the case of first seizure, based on prior studies, two principal
hypotheses are proposed. First, that the majority of patients with a
single unprovoked seizure will not have further seizures and thus do not
require anticonvulsant therapy; second, that there are predictive variables
such as the EEG and neurological examination which will allow selection of
a subgroup with a high recurrance risk. Children and adolescents with a
first provoked seizure will be evaluated with a detailed history,
neurological examination and an EEG. With few exceptions outlined in the
research plan they will not be treated with long term anticonvulsant
therapy. They will then be followed for several years. Those with a
second seizure will be treated. The data will be analyzed with special
emphasis on the probability of recurrence and on identifying significant
prognostic variables. Based on prior studies, three hypotheses are advanced regarding children
with epilepsy who have been seizure free for two or more years: first,
that over 70% will remain seizure free when medications are discontinued;
second, that utilizing a few predictive variables, the EEG, age of onset
and seizure type,one can identify subgroups with excellent and poor
prognosis; third, that most children who will relapse will do so within two
years. Patients who are seizure free for two or more years will be
evaluated and medications discontinued (see research plan for exceptions).
They will then be prospectively followed for seizure recurrence. Data will
be analyzed in terms of recurrence rate, prognostic variables and time to
recurrence. An attempt will be made to validate the importance of the
predictive variables which were found to be predictive in previous smaller
scale trials. The data obtained from this research will be important in deciding which
patients with a first seizure need to be treated and how long one needs to
treat patients who are well controlled. Both these issues are of prime
importance to the clinician dealing with epilepy.
StatusFinished
Effective start/end date1/1/8512/31/89

ASJC

  • Medicine(all)
  • Neuroscience(all)