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:
- 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
- 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
- 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