Araştırma Makalesi
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Risk Factors for Seizure Recurrence in Children Following an Unprovoked Seizure

Yıl 2025, Cilt: 10 Sayı: 3, 102 - 107, 29.08.2025
https://doi.org/10.70852/tmj.1760398

Öz

Objective: The aim of this study was to identify the risk factors for seizure recurrence in children who have experienced an unprovoked seizure and have normal sleep electroencephalogram (EEG). Method: The study population included 80 children who presented with first unprovoked seizure and had normal sleep EEG in the first week of the seizure. Demographic data and characteristics of the seizure were recorded from patient files. Patients were evaluated for seizure recurrence at the first year of the initial seizure and classified into two groups: Group 1 (no seizure recurrence) and Group 2 (seizure recurred). Results: The study population comprised 80 patients. The mean age at presentation was 82.3 ± 56.1 months. The first seizure type was generalized in 77.5% of the patients, with a mean seizure duration of 5 minutes. Group 2, consisted of 35 patients (44%) who had seizure recurrence during the first year. Seizure recurrence was within the first 6 months in 29 (83%) of the patients. There was no significant difference in terms of age, gender, consanguinity, birth history, mental development, presence of seizure or epilepsy in the family, seizure type, seizure duration, seizure occurring at sleep or awake time, and the number of seizures in the first 24 hours and cranial imaging findings between group 1 and group 2. Discussion: Following a first unprovoked seizure, we could not find any risk factor for recurrence of the seizure in the children who have normal EEG evaluation. We suggest larger series and extended follow-up will be helpful to identify the risk factors for recurrence in this population.

Kaynakça

  • Berg, A. T. (2008). Risk of recurrence after a first unprovoked seizure. Epilepsia, 49 Suppl 1, 13-18. https://doi.org/10.1111/j.1528-1167.2008.01444.x
  • Berg, A. T., & Shinnar, S. (1991). The risk of seizure recurrence following a first unprovoked seizure: a quantitative review. Neurology, 41(7), 965-972. https://doi.org/10.1212/wnl.41.7.965
  • Berg, A. T., Testa, F. M., Levy, S. R., & Shinnar, S. (2000). Neuroimaging in children with newly diagnosed epilepsy: A community-based study. Pediatrics, 106(3), 527-532. https://doi.org/10.1542/peds.106.3.527
  • Chen, X. Y., Zhou, F. H., Tan, G., Chen, D., & Liu, L. (2024). Risk of recurrence after a first unprovoked seizure with different risk factors: A 10-year prospective cohort study. Epilepsy Res, 207, 107457. https://doi.org/10.1016/j.eplepsyres.2024.107457
  • Debicki, D. B. (2017). Electroencephalography after a single unprovoked seizure. Seizure, 49, 69-73. https://doi.org/https://doi.org/10.1016/j.seizure.2017.03.001
  • Falco-Walter, J. J., Scheffer, I. E., & Fisher, R. S. (2018). The new definition and classification of seizures and epilepsy. In Epilepsy Research (Vol. 139, pp. 73-79).
  • Fisher, R. S., Acevedo, C., Arzimanoglou, A., Bogacz, A., Cross, J. H., Elger, C. E., Engel, J., Jr., Forsgren, L., French, J. A., Glynn, M., Hesdorffer, D. C., Lee, B. I., Mathern, G. W., Moshé, S. L., Perucca, E., Scheffer, I. E., Tomson, T., Watanabe, M., & Wiebe, S. (2014). ILAE official report: a practical clinical definition of epilepsy. Epilepsia, 55(4), 475-482. https://doi.org/10.1111/epi.12550
  • Fisher, R. S., van Emde Boas, W., Blume, W., Elger, C., Genton, P., Lee, P., & Engel, J., Jr. (2005). Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia, 46(4), 470-472. https://doi.org/10.1111/j.0013-9580.2005.66104.x
  • Garcia Pierce, J., Aronoff, S., & Del Vecchio, M. (2017). Systematic Review and Meta-analysis of Seizure Recurrence After a First Unprovoked Seizure in 815 Neurologically and Developmentally Normal Children. J Child Neurol, 32(13), 1035-1039. https://doi.org/10.1177/0883073817726461
  • Jiménez-Villegas, M. J., Lozano-García, L., & Carrizosa-Moog, J. (2021). Update on first unprovoked seizure in children and adults: A narrative review. Seizure, 90, 28-33. https://doi.org/10.1016/j.seizure.2021.03.027
  • Kanemura, H., Sano, F., Ohyama, T., Mizorogi, S., Sugita, K., & Aihara, M. (2015). EEG characteristics predict subsequent epilepsy in children with their first unprovoked seizure. Epilepsy Res, 115, 58-62. https://doi.org/10.1016/j.eplepsyres.2015.05.011
  • Mohamad, M. (2020). Seizures in childhood. In Nelson Textbook of Pediatrics (21st ed ed., pp. 3086-3121).  Elsevier.
  • Ramos Lizana, J., Cassinello Garciá, E., Carrasco Marina, L. L., Vázquez López, M., Martín González, M., & Muñoz Hoyos, A. (2000). Seizure recurrence after a first unprovoked seizure in childhood: a prospective study. Epilepsia, 41(8), 1005-1013. https://doi.org/10.1111/j.1528-1157.2000.tb00286.x
  • Shinnar, S., Berg, A. T., Moshe, S. L., O’Dell, C., Alemany, M., Newstein, D., Kang, H., Goldensohn, E. S., & Hauser, W. A. (1996). The risk of seizure recurrence after a first unprovoked afebrile seizure in childhood: an extended follow-up. Pediatrics, 98(2 Pt 1), 216-225.
  • Shinnar, S., O’Dell, C., Mitnick, R., Berg, A. T., & Moshe, S. L. (2001). Neuroimaging abnormalities in children with an apparent first unprovoked seizure. Epilepsy Res, 43(3), 261-269. https://doi.org/10.1016/s0920-1211(00)00206-0
  • Stafstrom, C. E., & Rho, J. M. (2017). 63 - Neurophysiology of Seizures and Epilepsy. In K. F. Swaiman, S. Ashwal, D. M. Ferriero, N. F. Schor, R. S. Finkel, A. L. Gropman, P. L. Pearl, & M. I. Shevell (Eds.), Swaiman’s Pediatric Neurology (Sixth Edition) (pp. 506-512). Elsevier. https://doi.org/10.1016/B978-0-323-37101-8.00063-1
  • Takami, Y., & Nakagawa, T. (2021). Risk of seizure recurrence after a first unprovoked seizure in childhood. Brain Dev, 43(8), 843-850. https://doi.org/10.1016/j.braindev.2021.04.005

Uyarılmamış Nöbet Sonrasında Çocuklarda Nöbet Tekrarı İçin Risk Faktörleri

Yıl 2025, Cilt: 10 Sayı: 3, 102 - 107, 29.08.2025
https://doi.org/10.70852/tmj.1760398

Öz

Amaç: Bu çalışmanın amacı, uyarılmamış nöbeti olan ve uyku elektroensefalogram (EEG) incelemesi normal olan çocuklarda nöbet tekrarı açısından risk faktörlerinin belirlenmesi Yöntem: Çalışma grubuna ilk uyarılmamış nöbet ile başvuran ve nöbetin ilk haftasında uyku EEG si normal olan 80 çocuk dahil edildi. Demografik bilgi ve nöbet özellikleri hasta dosyalarından kaydedildi. Hastalar, ilk nöbetin 1. yılında nöbet tekrarı açısından değerlendirildi ve iki grupta sınıflandırıldı: Grup 1 (nöbeti tekrarlamayan) ve Grup 2 (nöbet tekrarı olan). Bulgular: Çalışma grubu 80 hastadan oluştu. Ortalama yaş 82,3 ± 56,1 ay idi. İlk nöbet tipi hastaların %77,5’ında jeneralize idi. Ortalama nöbet süresi 5 dk idi. Grup 2, ilk yılda nöbet tekrarı olan 35 hastadan (%44) oluşmakta idi. Nöbet tekrarı, 29 (%83) hastada ilk 6 ay içerisinde idi. Yaş, cinsiyet, akrabalık, doğum öyküsü, mental gelişim, ailede nöbet veya epilepsi öyküsü, nöbet tipi, nöbet süresi, nöbetin uykuda ya da uyanık olması, ilk 24 saatte nöbet sayısı ve kranial görüntüleme bulguları açısından grup 1 ve grup 2 arasında anlamlı fark bulunmadı. Tartışma: İlk unprovoke nöbeti takiben, EEG incelemesi normal olan çocuklarda nöbet tekrarı açısından herhangi bir risk faktörü bulamadık. Daha geniş seriler ve daha uzun izlem süresinin bu grupta nöbet tekrarı için risk faktörlerini belirlemede faydalı olacağını düşünüyoruz.

Kaynakça

  • Berg, A. T. (2008). Risk of recurrence after a first unprovoked seizure. Epilepsia, 49 Suppl 1, 13-18. https://doi.org/10.1111/j.1528-1167.2008.01444.x
  • Berg, A. T., & Shinnar, S. (1991). The risk of seizure recurrence following a first unprovoked seizure: a quantitative review. Neurology, 41(7), 965-972. https://doi.org/10.1212/wnl.41.7.965
  • Berg, A. T., Testa, F. M., Levy, S. R., & Shinnar, S. (2000). Neuroimaging in children with newly diagnosed epilepsy: A community-based study. Pediatrics, 106(3), 527-532. https://doi.org/10.1542/peds.106.3.527
  • Chen, X. Y., Zhou, F. H., Tan, G., Chen, D., & Liu, L. (2024). Risk of recurrence after a first unprovoked seizure with different risk factors: A 10-year prospective cohort study. Epilepsy Res, 207, 107457. https://doi.org/10.1016/j.eplepsyres.2024.107457
  • Debicki, D. B. (2017). Electroencephalography after a single unprovoked seizure. Seizure, 49, 69-73. https://doi.org/https://doi.org/10.1016/j.seizure.2017.03.001
  • Falco-Walter, J. J., Scheffer, I. E., & Fisher, R. S. (2018). The new definition and classification of seizures and epilepsy. In Epilepsy Research (Vol. 139, pp. 73-79).
  • Fisher, R. S., Acevedo, C., Arzimanoglou, A., Bogacz, A., Cross, J. H., Elger, C. E., Engel, J., Jr., Forsgren, L., French, J. A., Glynn, M., Hesdorffer, D. C., Lee, B. I., Mathern, G. W., Moshé, S. L., Perucca, E., Scheffer, I. E., Tomson, T., Watanabe, M., & Wiebe, S. (2014). ILAE official report: a practical clinical definition of epilepsy. Epilepsia, 55(4), 475-482. https://doi.org/10.1111/epi.12550
  • Fisher, R. S., van Emde Boas, W., Blume, W., Elger, C., Genton, P., Lee, P., & Engel, J., Jr. (2005). Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia, 46(4), 470-472. https://doi.org/10.1111/j.0013-9580.2005.66104.x
  • Garcia Pierce, J., Aronoff, S., & Del Vecchio, M. (2017). Systematic Review and Meta-analysis of Seizure Recurrence After a First Unprovoked Seizure in 815 Neurologically and Developmentally Normal Children. J Child Neurol, 32(13), 1035-1039. https://doi.org/10.1177/0883073817726461
  • Jiménez-Villegas, M. J., Lozano-García, L., & Carrizosa-Moog, J. (2021). Update on first unprovoked seizure in children and adults: A narrative review. Seizure, 90, 28-33. https://doi.org/10.1016/j.seizure.2021.03.027
  • Kanemura, H., Sano, F., Ohyama, T., Mizorogi, S., Sugita, K., & Aihara, M. (2015). EEG characteristics predict subsequent epilepsy in children with their first unprovoked seizure. Epilepsy Res, 115, 58-62. https://doi.org/10.1016/j.eplepsyres.2015.05.011
  • Mohamad, M. (2020). Seizures in childhood. In Nelson Textbook of Pediatrics (21st ed ed., pp. 3086-3121).  Elsevier.
  • Ramos Lizana, J., Cassinello Garciá, E., Carrasco Marina, L. L., Vázquez López, M., Martín González, M., & Muñoz Hoyos, A. (2000). Seizure recurrence after a first unprovoked seizure in childhood: a prospective study. Epilepsia, 41(8), 1005-1013. https://doi.org/10.1111/j.1528-1157.2000.tb00286.x
  • Shinnar, S., Berg, A. T., Moshe, S. L., O’Dell, C., Alemany, M., Newstein, D., Kang, H., Goldensohn, E. S., & Hauser, W. A. (1996). The risk of seizure recurrence after a first unprovoked afebrile seizure in childhood: an extended follow-up. Pediatrics, 98(2 Pt 1), 216-225.
  • Shinnar, S., O’Dell, C., Mitnick, R., Berg, A. T., & Moshe, S. L. (2001). Neuroimaging abnormalities in children with an apparent first unprovoked seizure. Epilepsy Res, 43(3), 261-269. https://doi.org/10.1016/s0920-1211(00)00206-0
  • Stafstrom, C. E., & Rho, J. M. (2017). 63 - Neurophysiology of Seizures and Epilepsy. In K. F. Swaiman, S. Ashwal, D. M. Ferriero, N. F. Schor, R. S. Finkel, A. L. Gropman, P. L. Pearl, & M. I. Shevell (Eds.), Swaiman’s Pediatric Neurology (Sixth Edition) (pp. 506-512). Elsevier. https://doi.org/10.1016/B978-0-323-37101-8.00063-1
  • Takami, Y., & Nakagawa, T. (2021). Risk of seizure recurrence after a first unprovoked seizure in childhood. Brain Dev, 43(8), 843-850. https://doi.org/10.1016/j.braindev.2021.04.005
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Çocuk Nörolojisi
Bölüm Araştırma Makalesi
Yazarlar

Emregül Işık 0000-0003-0162-6745

Deniz Yılmaz 0000-0002-0789-8955

Yavuz Gürer 0000-0003-0004-0769

Yayımlanma Tarihi 29 Ağustos 2025
Gönderilme Tarihi 7 Ağustos 2025
Kabul Tarihi 20 Ağustos 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 10 Sayı: 3

Kaynak Göster

APA Işık, E., Yılmaz, D., & Gürer, Y. (2025). Risk Factors for Seizure Recurrence in Children Following an Unprovoked Seizure. Turkish Medical Journal, 10(3), 102-107. https://doi.org/10.70852/tmj.1760398

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