5Years Follow-up Study After A First Unprovoked Seizure In Infants

Objective：To analyze the recurrence after a first unprovoked seizure in infant (1month to3-year-old) with the method of cohort studies, and to discuss the recurrence riskafter a first unprovoked seizure.Methods：We studied the children with a first unprovoked seizure who receivedhospitalization or outpatient treatment from Apr.2009to Apr.2011in the neurologydepartment of Soochow University Affiliated Children’s Hospital, and kept records of thesituation of the patients, including general condition, birth history, past history, familyhistory, conditions during seizure, and laboratory examination result. The children werefollowed-up once every1-3months, until Apr.2014, the recurrence, symptom, andintervals were recorded during the follow-up. We analyzed the risk factors withKaplan-Meier method and Cox’s proportional hazards regression model.Results：1058patients were recorded during the study,190patients were enrolled inthis study. Data showed the recurrence of a first unprovoked seizure in6months,1year,2years,3years,4years and5years were32.6%、39.0%、45.0%、47.9%、51.8%and51.8%.Most recurrence (81.91%) was within1year after the first episode of seizure. As the timewent, the recurrence decreased, and seldom recurred after4years. Single factor analysisshowed recurrence could be affected by age, pathological cause, onset of seizure duringsleep, status epilepticus, type of seizure, EEG and neuroimaging. Multi-factor analysisshowed that age within1year old, symptomatic seizure, onset of seizure during sleep andepileptic discharge were the independent risk factors.Conclusions：The recurrence of seizure after the first episode of unprovoked seizureis common, risk factors include age1year old, symptomatic seizure, onset of seizureduring sleep and epileptic discharge were independent. Since there are relationship amongthe risk factors, we need to observe and analyze more cases and multicenter studies to build a better model of recurrence risk.