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Which patients are at highest risk for recurrent seizures
Seizure recurrence is more likely if the patient has focal neurologic deficits, developmental delay, a structural brain lesion, or an EEG that demonstrates epileptiform abnormalities.
In these patients, it is reasonable to begin antiepileptic therapy.
In patients with a well-defined provocative etiology, it is best to treat the underlying process rather than or in concert with the seizures themselves, for example, in clear-cut cases of alcohol withdrawal seizures and drug-induced seizures
Sources
- Chang BS, Lowenstein DH, Quality Standards Subcommittee of the American Academy of Neurology: Practice parameter: Antiepileptic drug prophylaxis in severe traumatic brain injury. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 60:10-16, 2003.
- Szaflarski JP, Nazzal Y, Dreer LE. Post-traumatic epilepsy: current and emerging treatment options. Neuropsychiatr Dis Treat 10:1469-1477, 2014.
- Gilbert DL, Sethuraman G, Kotagal U, et al.: Meta-analysis of EEG test performance shows wide variation among studies. Neurology 60:564-570, 2003.
- O’Brien TJ, So EL, Mullan BP, et al.: Subtraction peri-ictal SPECT is predictive of extratemporal epilepsy surgery outcome. Neurology 55:1668-1677, 2000.
