TY - JOUR
T1 - Do occasional brief seizures cause detectable clinical consequences?
AU - Shinnar, Shlomo
AU - Hauser, W. Allen
N1 - Funding Information:
Supported in part by Grant R01 NS26151 (to S.S.) from the National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD.
PY - 2002
Y1 - 2002
N2 - Seizures, particularly when prolonged or frequent, have been associated with a variety of adverse outcomes. However, epidemiological data provide little evidence for adverse effects of isolated brief seizures per se. Even the animal data is mostly for prolonged or frequent seizures. Febrile seizures lasting <10 min have not been associated with adverse seizures or cognitive outcomes. Treating either febrile seizures or other acute symptomatic seizures does not reduce the risk of subsequent epilepsy. In subjects with a first unprovoked seizure, seizure duration does not influence recurrence risk. Furthermore, treatment after a first unprovoked seizure reduces recurrence risk, but does not alter long-term prognosis. In epidemiological studies of newly diagnosed epilepsy, the number of seizures prior to therapy does not influence prognosis. There are a variety of specific epilepsy syndromes associated with poor cognitive outcomes and with progressive loss of function. However, the poor outcomes in these syndromes do not appear to be the result of seizures per se but rather to the specific syndrome and to the frequent interictal spike activity seen in these patients. Antiepileptic drugs, while effective in reducing seizure recurrence are also associated with a variety of potential adverse effects. On a risk-benefit basis, the available epidemiologic data do not justify starting treatment after the first seizure to attempt to influence long-term prognosis.
AB - Seizures, particularly when prolonged or frequent, have been associated with a variety of adverse outcomes. However, epidemiological data provide little evidence for adverse effects of isolated brief seizures per se. Even the animal data is mostly for prolonged or frequent seizures. Febrile seizures lasting <10 min have not been associated with adverse seizures or cognitive outcomes. Treating either febrile seizures or other acute symptomatic seizures does not reduce the risk of subsequent epilepsy. In subjects with a first unprovoked seizure, seizure duration does not influence recurrence risk. Furthermore, treatment after a first unprovoked seizure reduces recurrence risk, but does not alter long-term prognosis. In epidemiological studies of newly diagnosed epilepsy, the number of seizures prior to therapy does not influence prognosis. There are a variety of specific epilepsy syndromes associated with poor cognitive outcomes and with progressive loss of function. However, the poor outcomes in these syndromes do not appear to be the result of seizures per se but rather to the specific syndrome and to the frequent interictal spike activity seen in these patients. Antiepileptic drugs, while effective in reducing seizure recurrence are also associated with a variety of potential adverse effects. On a risk-benefit basis, the available epidemiologic data do not justify starting treatment after the first seizure to attempt to influence long-term prognosis.
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U2 - 10.1016/S0079-6123(02)35022-2
DO - 10.1016/S0079-6123(02)35022-2
M3 - Article
C2 - 12143343
AN - SCOPUS:0036454603
SN - 0079-6123
VL - 135
SP - 221
EP - 235
JO - Progress in Brain Research
JF - Progress in Brain Research
ER -