What is the prognosis of first adult seizure?

Updated: Nov 30, 2017
  • Author: Eissa Ibrahim AlEissa, MD, MBBS; Chief Editor: Selim R Benbadis, MD  more...
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A first seizure provoked by an acute brain insult is unlikely to recur (3-10%), whereas a first unprovoked seizure has a recurrence risk of 30-50% over the next 2 years. Even among symptomatic seizures, the recurrence rate differs according to the underlying cause. Seizures associated with reversible metabolic or toxic disturbances are associated with a minor risk of subsequent epilepsy (3% or less based on large case series). Seizures provoked by disorders that cause permanent damage to the brain, such as brain abscess, have a higher risk of recurrence (10% or more). [8]

In a 2009 study, individuals with a first acute symptomatic seizure were found to be significantly more likely to die in the first 30 days after the seizure compared with those with a first unprovoked seizure [27] ; however, the risk of 10-year mortality did not differ. In addition, the risk for subsequent unprovoked seizure was 80% lower in the group with first acute symptomatic seizure compared with those with first unprovoked seizure. [27]

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