What is the prognosis of pediatric first seizure?

Updated: Aug 16, 2018
  • Author: Shelley R Waite, MD; Chief Editor: Amy Kao, MD  more...
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Answer

Answer

Giving a definitive prognosis after a single seizure is difficult, but some general rules do apply, based on epidemiologic data.

In general, children who have a single, short, generalized seizure along with normal neurologic development and normal findings on neurologic examination are estimated to have a 24% risk of having another seizure within 1 year and a 36% chance of having a second seizure within 3 years. In these children, if the electroencephalogram (EEG) is found to be normal, the risk of seizure recurrence is estimated to decrease to approximately 15% within 1 year and 26% within 3 years. If the EEG is found to be abnormal, approximately 41% will have another seizure within 1 year and 56% within 3 years.

Children with developmental problems, structural central nervous system (CNS) lesions, or focal neurologic deficits have a 37% risk of having another seizure within 1 year and 60% risk of having another seizure within 3 years.

If a child has a second unprovoked seizure, the risk for further seizures is greater than 50%, even among children without other risk factors. [12, 14, 15] Identifying the seizure as part of a syndrome has additional predictive value. For example, patients with simple febrile seizures will likely have spontaneous remission as they enter school-age years; however, patients with juvenile myoclonic epilepsy are likely to have lifelong seizure recurrence. [16]


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