Titre
Survey of management of first-ever seizures in a hospital based community.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Kawkabani, A.
Auteure/Auteur
Rossetti, A.O.
Auteure/Auteur
Despland, P.A.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1424-7860
Statut éditorial
Publié
Date de publication
2004-10-02
Volume
134
Numéro
39-40
Première page
586
Dernière page/numéro d’article
592
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Epidemiological studies focusing on first-ever seizures have been carried out mainly on community based populations. However, since hospital populations may display varying clinical features, we prospectively analysed patients with first-ever seizure in a hospital based community to evaluate prognosis and the role of complementary investigations in the decision to administer antiepileptic drugs (AED).
Over one year, we recruited 177 consecutive adult patients with a first seizure acutely evaluated in our hospital. During six months' follow-up data relating to AED treatment, recurrence of seizures and death were collected for each patient.
Neurological examination was abnormal in 72.3%, neuroimaging in 54.8% and biochemical tests in 57.1%. Electroencephalogram (EEG) showed epileptiform features in 33.9%. Toxicity represented the most common aetiology. AED was prescribed in 51% of patients. Seizure recurrence at six months involved 31.6% of patients completing the follow-up; mortality was 17.8%. Statistical analysis showed that brain CT, EEG and neurological examination are independent predictive factors for AED administration, but only CT scan is associated with outcome.
Patients evaluated acutely for first-ever seizure in a hospital setting have severe underlying clinical conditions apparently related to their relatively poor prognosis. Neuroimaging represents the most important paraclinical test in predicting both treatment administration and outcome.
Over one year, we recruited 177 consecutive adult patients with a first seizure acutely evaluated in our hospital. During six months' follow-up data relating to AED treatment, recurrence of seizures and death were collected for each patient.
Neurological examination was abnormal in 72.3%, neuroimaging in 54.8% and biochemical tests in 57.1%. Electroencephalogram (EEG) showed epileptiform features in 33.9%. Toxicity represented the most common aetiology. AED was prescribed in 51% of patients. Seizure recurrence at six months involved 31.6% of patients completing the follow-up; mortality was 17.8%. Statistical analysis showed that brain CT, EEG and neurological examination are independent predictive factors for AED administration, but only CT scan is associated with outcome.
Patients evaluated acutely for first-ever seizure in a hospital setting have severe underlying clinical conditions apparently related to their relatively poor prognosis. Neuroimaging represents the most important paraclinical test in predicting both treatment administration and outcome.
PID Serval
serval:BIB_9873D11A2A6E
PMID
Date de création
2008-01-25T10:40:47.701Z
Date de création dans IRIS
2025-05-20T23:08:51Z
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15592950.pdf
Version du manuscrit
published
Taille
289.22 KB
Format
Adobe PDF
PID Serval
serval:BIB_9873D11A2A6E.P001
URN
urn:nbn:ch:serval-BIB_9873D11A2A6E5
Somme de contrôle
(MD5):3c6f839d3488e138187d79c7a780348c