Pediatric Seizure Recurrence

Recurrence rate after first unprovoked seizure 1:
  • 6% recurrence within 48 hours ( 1 in 16 )
  • 15.8% recurrence within 14 days (1 in 6)
  • 31.5% recurrence within 4 months ( 1 in 3 )
  • Age less than 3 yo at onset increases 14 days recurrence, OR 2.1
  • 29% recurrence within 1 year 3
  • 37% recurrence within 2 years 3
  • 43% recurrence within 5 years 3
  • 46% recurrence within 10 years 3
Recurrence rate after second unprovoked seizure rises to 72% 3
Recommendations 2,3:
  • Defer EEG testing to outpatient follow up
  • Start Anti-Epileptic meds on: (preferably with neurology consultation)
    • Children <3 yo
    • Children with multiple seizures in 24 hrs
    • Those with poor outpatient access
References:
  1. Goldberg LR, Kernie CG, Lillis K, et al. Early Recurrence of First Unprovoked Seizures in Children. Acad Emerg Med. 2018;25(3):275-282. PubMed
  2. Wendt WL, Dang LT, Rogers AJ. What Happens Next? Recurrence Rates for First Unprovoked Seizures in Children. Acad Emerg Med. 2018;25(3):362-364. PubMed
  3. Shinnar S, Berg AT, O’dell C, Newstein D, Moshe SL, Hauser WA. Predictors of multiple seizures in a cohort of children prospectively followed from the time of their first unprovoked seizure. Ann Neurol. 2000;48(2):140-7.PubMed

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