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Titolo:
TREATMENT OF FIRST TONIC-CLONIC SEIZURE DOES NOT IMPROVE THE PROGNOSIS OF EPILEPSY
Autore:
MUSICCO M; BEGHI E; SOLARI A; VIANI F;
Indirizzi:
CNR,IST TECNOL BIOMED AVANZATE,VIA FILLI CERVI 93 I-20090 SAGRATE MI ITALY CNR,IST TECNOL BIOMED AVANZATE MILAN ITALY IST MEDITERRANEO NEUROSCI NEUROMED POZZILLI IS ITALY IST RIC FARMACOL MARIO NEGRI MILAN ITALY IST NAZL NEUROL C BESTA,DEPT EPIDEMIOL MILAN ITALY CLIN PEDIAT G&D DE MARCHI MILAN ITALY
Titolo Testata:
Neurology
fascicolo: 4, volume: 49, anno: 1997,
pagine: 991 - 998
SICI:
0028-3878(1997)49:4<991:TOFTSD>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
1ST UNPROVOKED SEIZURE; UNTREATED EPILEPSY; RECURRENCE; CHILDHOOD; CARBAMAZEPINE; VALPROATE; TRIAL; RISK; LIFE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
29
Recensione:
Indirizzi per estratti:
Citazione:
M. Musicco et al., "TREATMENT OF FIRST TONIC-CLONIC SEIZURE DOES NOT IMPROVE THE PROGNOSIS OF EPILEPSY", Neurology, 49(4), 1997, pp. 991-998

Abstract

It is widely agreed that after two or more seizures patients should be given antiepileptic treatment, but there is still controversy about the treatment of patients after a first unprovoked seizure. In a multicenter, randomized, open trial, patients with a first tonic-clonic seizure were randomized to immediate treatment (carbamazepine, phenytoin,phenobarbital, or sodium valproate) or to treatment only after another seizure. Fifty-two (24%) of the 215 patients randomized to immediatetreatment and 85 (42%) of the 204 randomized to delayed treatment experienced seizure recurrence during follow-up. Age, acute treatment of the seizure with benzodiazepines, remote etiologic factors, and EEG abnormalities were significant predictors of relapse. Of the immediatelytreated patients, 87% had no seizures for a year and 68% had no seizures for 2 years, whereas only slightly fewer initially untreated patients (83% and 60%) achieved these endpoints. Patients treated after thefirst seizure and those treated after seizure relapse had the same time-dependent probability of achieving 1 and 2 seizure-free years. Noneof the variables that were prognostic predictors of relapse was significantly associated with the probability of having 1 or 2 years of seizure control. Anticonvulsants in patients presenting a first tonic-clonic seizure reduce the risk of relapse; however, 50% of patients who are not treated will never experience a second seizure. Moreover, the probability of long-term remission is not influenced by treatment of the first seizure.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 04:14:58