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Outcome of seizures in the general population after 25 years: a prospective follow-up, observational cohort study

Bell, GS; Neligan, A; Giavasi, C; Keezer, MR; Novy, J; Peacock, JL; Johnson, AL; ... Sander, JW; + view all (2016) Outcome of seizures in the general population after 25 years: a prospective follow-up, observational cohort study. Journal of Neurology, Neurosurgery & Psychiatry , 87 (8) pp. 843-850. 10.1136/jnnp-2015-312314. Green open access

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Abstract

OBJECTIVES: We investigated long-term (to 25 years) seizure prognosis and survival in people with newly diagnosed epilepsy in the community. We explored whether prognosis is different in those with epilepsy (>2 unprovoked seizures) and those with a single seizure at presentation. METHODS: This is a prospective observational cohort study of people with newly diagnosed seizures. We investigated seizure outcome and survival in people presenting with a single seizure and in those presenting with >2 seizures (epilepsy). RESULTS: 695 people (median follow-up 23.6 years) had unprovoked epileptic seizures. For seizure analysis we excluded 38 people with missing data leaving 657 (309 male, and 249 aged <18 years). Seizures recurred in 67%. The 354 people with epilepsy were only slightly more likely to have further seizure recurrence than the 302 people with a single seizure at presentation (HR 1.32, 95% CI 1.09 to 1.59). In 327 people with complete follow-up, 268 (82%, 95% CI 77% to 86%) were in terminal remission; (80%, (95% CI 73% to 85%) in those with epilepsy at presentation). Premature mortality was increased in people with epilepsy (standardised mortality ratio 1.67; 95% CI 1.40 to 1.99) and those with a single seizure at presentation (standardised mortality ratio 2.65; 95% CI 2.23 to 3.15). It is also high in those with early remission. CONCLUSIONS: People with epilepsy and with single seizures at presentation in the community generally have good prognosis for seizure control with prolonged follow-up. The risk of premature mortality is significantly increased in both groups.

Type: Article
Title: Outcome of seizures in the general population after 25 years: a prospective follow-up, observational cohort study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/jnnp-2015-312314
Publisher version: http://dx.doi.org/10.1136/jnnp-2015-312314
Language: English
Additional information: Copyright © 2016 by the BMJ Publishing Group Ltd. All rights reserved. This article has been accepted for publication in Journal of Neurology, Neurosurgery & Psychiatry following peer review. The definitive copyedited, typeset version Bell, GS; Neligan, A; Giavasi, C; Keezer, MR; Novy, J; Peacock, JL; Johnson, AL; (2016) Outcome of seizures in the general population after 25 years: a prospective follow-up, observational cohort study, is available online at: http://jnnp.bmj.com/content/early/2016/01/18/jnnp-2015-312314
Keywords: Epilepsy; seizure disorder; prognosis; mortality; single seizure
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
URI: https://discovery.ucl.ac.uk/id/eprint/1477062
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