Treatment of first tonic-clonic seizure does not improve the prognosis of epilepsy (Articolo in rivista)

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Label
  • Treatment of first tonic-clonic seizure does not improve the prognosis of epilepsy (Articolo in rivista) (literal)
Anno
  • 1997-01-01T00:00:00+01:00 (literal)
Alternative label
  • Musicco, M; Beghi, E; Solari, A; Viani, F (1997)
    Treatment of first tonic-clonic seizure does not improve the prognosis of epilepsy
    in Neurology
    (literal)
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  • Musicco, M; Beghi, E; Solari, A; Viani, F (literal)
Pagina inizio
  • 991 (literal)
Pagina fine
  • 998 (literal)
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  • 49 (literal)
Rivista
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  • 8 (literal)
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  • 4 (literal)
Note
  • ISI Web of Science (WOS) (literal)
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  • Consiglio Nazionale delle Ricerche (CNR); IST MEDITERRANEO NEUROSCI NEUROMED; Mario Negri Institute for Pharmacological Research; Istituto Nazionale Neurologico C. Besta; CLIN PEDIAT G&D DE MARCHI (literal)
Titolo
  • Treatment of first tonic-clonic seizure does not improve the prognosis of epilepsy (literal)
Abstract
  • It is widely agreed that after two or more seizures patients should be given antiepileptic treatment, but there is still controversy about the treatment of patients after a first unprovoked seizure. In a multicenter, randomized, open trial, patients with a first tonic-clonic seizure were randomized to immediate treatment (carbamazepine, phenytoin, phenobarbital, or sodium valproate) or to treatment only after another seizure. Fifty-two (24%) of the 215 patients randomized to immediate treatment and 85 (42%) of the 204 randomized to delayed treatment experienced seizure recurrence during follow-up. Age, acute treatment of the seizure with benzodiazepines, remote etiologic factors, and EEG abnormalities were significant predictors of relapse. Of the immediately treated patients, 87% had no seizures for a year and 68% had no seizures for 2 years, whereas only slightly fewer initially untreated patients (83% and 60%) achieved these endpoints. Patients treated after the first seizure and those treated after seizure relapse had the same time-dependent probability of achieving 1 and 2 seizure-free years. None of the variables that were prognostic predictors of relapse was significantly associated with the probability of having 1 or 2 years of seizure control. Anticonvulsants in patients presenting a first tonic-clonic seizure reduce the risk of relapse; however, 50% of patients who are not treated will never experience a second seizure. Moreover, the probability of long-term remission is not influenced by treatment of the first seizure. (literal)
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