Health Dictionary
Reliable, easy-to-read patient information on common medical conditions β written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Seizure natural history, complications and prognosis
Introduction
Overview
Overview
The recurrence rate of seizure within two years is 35% to 40% in patients with a first-time unprovoked seizure. Status epilepticus occurs in about 6%-7% of the patients with seizure in the emergency department (ED). The overall mortality rate of status epilepticus is approximately 22% (3% in pediatric patients to 26% in adults). Simple febrile seizures are considered normal in childhood and the prognosis is generally excellent. The recurrence rate is about 12% in children that have their first febrile seizure in infancy and about 50% in those who have their first febrile seizure later.
Natural History, Complications, and Prognosis
Natural History, Complications, and Prognosis
Natural History
- The recurrence rate of seizure within 2 years is 35% to 40% in patients with a first-time unprovoked seizure.[1]
- In a cohort study that followed patients for 10 years after an acute symptomatic seizure in an ED visit (excluding children with febrile seizure), the risk of recurrence was 13% in those patients who had an unprovoked seizure and 41% in those who had acute symptomatic status epilepticus.[2]
- Status epilepticus occurs in about 6%-7% of the patients with seizure in the emergency department (ED).[3][4][5]
Complications
Some complications that have been suggested in seizure include:[6]
- Accidents and injuries
- Mostly cranial soft tissue contusions or lacerations
- Lifestyle and psychosocial impact
- Financial, social, and relationship problems such as driving, work-related activities, reduced productivity, stigma in society
- Comorbidities
- Medical: stroke, ischaemic heart disease, cancer, migraine, vertigo, and sleep disorders
- Psychiatric: depression and anxiety
- Neurodegenerative diseases: dementia and Alzheimer disease (AD)
- Death
Prognosis
- Simple febrile seizures are considered normal in childhood and the prognosis is generally excellent.
- The recurrence rate is about 12% in children that have their first febrile seizure in infancy and about 50% in those who have their first febrile seizure later.[7][8]
- The risk of epilepsy is the same as children without any history of febrile seizure.
- Complex febrile seizures increase the risk for epilepsy, and but do not increase the risk for a future simple febrile seizure.[9]
- The overall mortality rate of status epilepticus is approximately 22% (3% in pediatric patients to 26% in adults).[10]
References
References
- β Berg AT, Testa FM, Levy SR, Shinnar S (1996). “The epidemiology of epilepsy. Past, present, and future”. Neurol Clin. 14 (2): 383β98. doi:10.1016/s0733-8619(05)70263-2. PMIDΒ 8827178.
- β Hesdorffer DC, Logroscino G, Cascino G, Annegers JF, Hauser WA (1998). “Risk of unprovoked seizure after acute symptomatic seizure: effect of status epilepticus”. Ann Neurol. 44 (6): 908β12. doi:10.1002/ana.410440609. PMIDΒ 9851435.
- β Huff JS, Morris DL, Kothari RU, Gibbs MA, Emergency Medicine Seizure Study Group (2001). “Emergency department management of patients with seizures: a multicenter study”. Acad Emerg Med. 8 (6): 622β8. doi:10.1111/j.1553-2712.2001.tb00175.x. PMIDΒ 11388937.
- β Krumholz A, Grufferman S, Orr ST, Stern BJ (1989). “Seizures and seizure care in an emergency department”. Epilepsia. 30 (2): 175β81. doi:10.1111/j.1528-1157.1989.tb05451.x. PMIDΒ 2924743.
- β Brinar V, BoziceviΔ D, Zurak N, Gubarev N, DjakoviΔ V (1991). “Epileptic seizures as a symptom of various neurological diseases”. Neurol Croat. 40 (2): 93β101. PMIDΒ 1883923.
- β Foster E, Carney P, Liew D, Ademi Z, O’Brien T, Kwan P (2019). “First seizure presentations in adults: beyond assessment and treatment”. J Neurol Neurosurg Psychiatry. 90 (9): 1039β1045. doi:10.1136/jnnp-2018-320215. PMIDΒ 30948624.
- β Kenney RD, Taylor JA (1992). “Absence of serum chemistry abnormalities in pediatric patients presenting with seizures”. Pediatr Emerg Care. 8 (2): 65β6. doi:10.1097/00006565-199204000-00001. PMIDΒ 1603702.
- β Walton DM, Thomas DC, Aly HZ, Short BL (2000). “Morbid hypocalcemia associated with phosphate enema in a six-week-old infant”. Pediatrics. 106 (3): E37. doi:10.1542/peds.106.3.e37. PMIDΒ 10969121.
- β Berg AT (1992). “Febrile seizures and epilepsy: the contributions of epidemiology”. Paediatr Perinat Epidemiol. 6 (2): 145β52. doi:10.1111/j.1365-3016.1992.tb00756.x. PMIDΒ 1584717.
- β DeLorenzo RJ, Hauser WA, Towne AR, Boggs JG, Pellock JM, Penberthy L; et al. (1996). “A prospective, population-based epidemiologic study of status epilepticus in Richmond, Virginia”. Neurology. 46 (4): 1029β35. doi:10.1212/wnl.46.4.1029. PMIDΒ 8780085.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]