Recurrence after a first unprovoked cryptogenic/idiopathic seizure was studied in 213 children followed at FCM-Unicamp, Campinas, SP, Brazil. Recurrence occurred in 34% of patients at a mean interval of 12 months. An abnormal EEG was a significant risk factor for seizure recurrence. Small calcifications found in 9.5% of CTs performed in 182 patients were not a predictor for recurrence. [1]
COMMENT. EEG but not CT abnormalities are predictors of seizure recurrence after a first unprovoked cryptogenic/idiopathic seizure.
In 82 patients with childhood-onset cryptogenic localization-related epilepsies controlled for 3 years or more, seizures recurred in 8(9.8%) after withdrawal of antiepileptic drugs [2]. Factors correlating with higher rates of seizure relapse included: 6 years of age or higher at epilepsy onset; 15 years of age or higher at start of AED withdrawal; 5 years or more from start of AED treatment to seizure control; 5 or more seizures before seizure control; and 2 or more AED to effect control. Independent risk factors for relapse were: 6 years of age or higher at onset, and 5 years or more from start of treatment to seizure control. These risk factors are of value in attempting AED withdrawal.