Practice parameter: Treatment of the child with a first unprovoked seizure: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society

D. Hirtz, A. Berg, D. Bettis, C. Camfield, P. Camfield, P. Crumrine, W. D. Gaillard, S. Schneider, Shlomo Shinnar

Research output: Contribution to journalArticle

158 Citations (Scopus)

Abstract

The Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society develop practice parameters as strategies for patient management based on analysis of evidence regarding risks and benefits. This parameter reviews published literature relevant to the decision to begin treatment after a child or adolescent experiences a first unprovoked seizure and presents evidence-based practice recommendations. Reasons why treatment may be considered are discussed. Evidence is reviewed concerning risk of recurrence as well as effect of treatment on prevention of recurrence and development of chronic epilepsy. Studies of side effects of anticonvulsants commonly used to treat seizures in children are also reviewed. Relevant articles are classified according to the Quality Standards Subcommittee classification scheme. Treatment after a first unprovoked seizure appears to decrease the risk of a second seizure, but there are few data from studies involving only children. There appears to be no benefit of treatment with regard to the prognosis for long-term seizure remission. Antiepileptic drugs (AED) carry risks of side effects that are particularly important in children. The decision as to whether or not to treat children and adolescents who have experienced a first unprovoked seizure must be based on a risk-benefit assessment that weighs the risk of having another seizure against the risk of chronic AED therapy. The decision should be individualized and take into account both medical issues and patient and family preference.

Original languageEnglish (US)
Pages (from-to)166-175
Number of pages10
JournalNeurology
Volume60
Issue number2
StatePublished - Jan 28 2003

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Neurology
Seizures
Anticonvulsants
Therapeutics
Recurrence
Patient Preference
Evidence-Based Practice
Only Child
Epilepsy
Drug Therapy

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Practice parameter : Treatment of the child with a first unprovoked seizure: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. / Hirtz, D.; Berg, A.; Bettis, D.; Camfield, C.; Camfield, P.; Crumrine, P.; Gaillard, W. D.; Schneider, S.; Shinnar, Shlomo.

In: Neurology, Vol. 60, No. 2, 28.01.2003, p. 166-175.

Research output: Contribution to journalArticle

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