10 Use EEG results as a guide in the management of idiopathic first seizure Following seizure recurrence in patients with presumed idiopathic first seizure, treatment is likely to benefit those with epileptic abnormalities seen on an electroencephalogram (EEG). 'Clearly, it is unwise to initiate treatment, , .' in patients with normal EEGs and '," the risk 0/ recurrence in patients with non-epikptic abnormalities also seems to be too low to warrant immediate treatment', Seizure recurrence rates were evaluated in 151 patients; the overall recurrence rate was 40% at 2 years. The 2-year cumulative risk of recurrence in the 16 patients with epileptic discharges was 100%, the risk in the 68 patients with nonepileptic abnormalities was 40% and the risk in the 67 oatients with a normal EEG was 25%. A further 19 patients were identified as having epileptic discharges according to an EEG performed after sleep deprivation; 12 had a further seizure. Of the evaluable patients who had a recurrence, 40 became seizure-free. 8 had sporadic seizures and 9 had continued seizures despite drug treatment. Of patients in the latter 2 groups, an EEG showed epileptic discharges in 10, non epileptic abnormalities in 6 and no abnormalities in I. Treatment was initiated immediately after the first recurrence in 25 patients, was delayed in 26 and withheld in 6. Overall, the outcome of those who received early treatment was better than those who received delayed treatment. van Donselaar CA. Geerts AT. Schimsheimer R-J. Idiopathic first seizure in adult life: who should be treated? British Medical Journal 302: 620-623. 16 Mar 1991 .. " _ 30 Mill' 1991 INPHARMA® ISSN 0156-2703/9//0330-0010/0101.00/0 0 Adis Il1tel7UltiolUli Ltd

Use EEG results as a guide in the management of idiopathic first seizure

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Use EEG results as a guide in the management of idiopathic first seizure

Following seizure recurrence in patients with presumed idiopathic first seizure, treatment is likely to benefit those with epileptic abnormalities seen on an electroencephalogram (EEG). 'Clearly, it is unwise to initiate treatment, , .' in patients with normal EEGs and '," the risk 0/ recurrence in patients with non-epikptic abnormalities also seems to be too low to warrant immediate treatment',

Seizure recurrence rates were evaluated in 151 patients; the overall recurrence rate was 40% at 2 years. The 2-year cumulative risk of recurrence in the 16 patients with epileptic discharges was 100%, the risk in the 68 patients with nonepileptic abnormalities was 40% and the risk in the 67 oatients with a normal EEG was 25%. A further 19 patients were identified as having epileptic discharges according to an EEG performed after sleep deprivation; 12 had a further seizure.

Of the evaluable patients who had a recurrence, 40 became seizure-free. 8 had sporadic seizures and 9 had continued seizures despite drug treatment. Of patients in the latter 2 groups, an EEG showed epileptic discharges in 10, non epileptic abnormalities in 6 and no abnormalities in I. Treatment was initiated immediately after the first recurrence in 25 patients, was delayed in 26 and withheld in 6. Overall, the outcome of those who received early treatment was better than those who received delayed treatment. van Donselaar CA. Geerts AT. Schimsheimer R-J. Idiopathic first seizure in adult life: who should be treated? British Medical Journal 302: 620-623. 16 Mar 1991 .. "

_ 30 Mill' 1991 INPHARMA® ISSN 0156-2703/9//0330-0010/0101.00/0 0 Adis Il1tel7UltiolUli Ltd