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

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Serval ID
serval:BIB_R_5742
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Survey of management of first-ever seizures in a hospital based community
Journal
Swiss medical weekly
Author(s)
Kawkabani A.
Publication state
Published
Issued date
2004
Peer-reviewed
Oui
Volume
134
Number
39-40
Pages
586-92.
Language
english
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.
Keywords
first-ever seizure, aetiology, prognosis, recurrence, AED, hospital cohort
Pubmed
Create date
09/12/2009 11:51
Last modification date
20/08/2019 17:30
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