Prognosis of provoked and unprovoked seizures

In this population-based study, residents of Rochester, Minnesota were included if they had experienced a first acute symptomatic seizure or a first unprovoked seizure between 1955 and 1984.¹ An acute symptomatic seizure was defined as a seizure occurring recently after a transient CNS insult or transient systemic disturbance.¹ Individuals were included only if their seizures had occurred in association with stroke, TBI, and CNS infection.¹

A total of 262 people had experienced a first acute symptomatic seizure and another 148 people had experienced a first unprovoked seizure during this timeframe.¹ Stroke was more commonly associated with the first unprovoked seizures compared with first symptomatic seizures (68.2% vs 34.7%), whereas TBI (25.0% vs 34.7%) and CNS infection (6.8% vs 30.6%) were less common aetiologies.¹

10-year mortality was similar between first provoked and first unprovoked seizures in those with stroke or TBI; however, among those with a first seizure related to a CNS infection, deaths were observed only in those with a first provoked seizure.¹

Reference:

1.Hesdorffer DC, Benn EKT, Cascino GD, Hauser WA. Is a first acute symptomatic seizure epilepsy? Mortality and risk for recurrent seizure. Epilepsia 2009; 50 (5): 1102‒1108.