Survey of management of first-ever seizures in a hospital based community.

Abstract:

BACKGROUND:Epidemiological studies focusing on first-ever seizures have been carried out mainly on community based populations. However, since hospital populations may display varying clinical features, we prospectively analysed patients with first-ever seizure in a hospital based community to evaluate prognosis and the role of complementary investigations in the decision to administer antiepileptic drugs (AED). METHODS:Over one year, we recruited 177 consecutive adult patients with a first seizure acutely evaluated in our hospital. During six months' follow-up data relating to AED treatment, recurrence of seizures and death were collected for each patient. RESULTS:Neurological examination was abnormal in 72.3%, neuroimaging in 54.8% and biochemical tests in 57.1%. Electroencephalogram (EEG) showed epileptiform features in 33.9%. Toxicity represented the most common aetiology. AED was prescribed in 51% of patients. Seizure recurrence at six months involved 31.6% of patients completing the follow-up; mortality was 17.8%. Statistical analysis showed that brain CT, EEG and neurological examination are independent predictive factors for AED administration, but only CT scan is associated with outcome. CONCLUSIONS:Patients evaluated acutely for first-ever seizure in a hospital setting have severe underlying clinical conditions apparently related to their relatively poor prognosis. Neuroimaging represents the most important paraclinical test in predicting both treatment administration and outcome.

journal_name

Swiss Med Wkly

journal_title

Swiss medical weekly

authors

Kawkabani A,Rossetti AO,Despland PA

doi

2004/39/smw-10738

keywords:

subject

Has Abstract

pub_date

2004-10-02 00:00:00

pages

586-92

issue

39-40

eissn

1424-7860

issn

1424-3997

pii

smw-10738

journal_volume

134

pub_type

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