Diagnostic Factors in Adult Males Following Initial Seizures

Johnson, Laverne C.; DeBolt, William L.; Long, Michael T.; Ross, John J.; Sassin, Jon F.; Arthur, Ransom J.; Walter, Richard D.

doi:10.1001/archneur.1972.00490150001001

Cited by 34 publications

(20 citation statements)

References 5 publications

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“…Cleland et al (1981) found risks of 53% in patients with EEG abnormalities, which included spike and wave and nonspecific slowing, compared with 26% in patients with normal EEGs. Johnson et al (1972) also observed increased recurrences among subjects with spike and wave on the EEG. Abnormal EEG findings in our study, which also included spike and wave, focal slowing, and nonspecific slowing, were associated with a twofold relative risk of recurrence when compared with normal readings, although specific epileptiform patterns were not more predictive than nonspecific abnormalities.…”

Section: Discussionmentioning

confidence: 77%

Risk of Recurrence After an Initial Unprovoked Seizure

Annegers

Shirts

Hauser³

et al. 1986

Epilepsia

195

125

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A cohort of 424 patients was followed to determine the patterns of risk for recurrence after an initial unprovoked seizure. Overall, the risk of recurrence was 36% by 1 year, 48% by 3 years, and 56% by 5 years. The risk of subsequent seizures was lower for patients with idiopathic seizures than for those whose seizures had a presumed etiology. Among cases for which initial seizure was classified as idiopathic, EEG abnormalities, abnormal neurologic examination findings, and initial partial seizures were identified as significant independent predictors of higher recurrence risks.

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Section: Discussionmentioning

confidence: 77%

Risk of Recurrence After an Initial Unprovoked Seizure

Annegers

Shirts

Hauser³

et al. 1986

Epilepsia

195

125

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“…Only one other study has mentioned any patient in whom the initial diagnosis proved to be wrong. 9 We believe that the diagnostic criteria were sufficiently reliable and accurate to allow decisions such as initiating antiepileptic drugs to be made. Doctors should beware, however, of cardiac arrhythmias even in young people.…”

Section: Discussionmentioning

confidence: 96%

“…We used survival analysis techniques (Kaplan-Meier). 9 The two patients who were lost to follow up were included in the analysis.…”

Section: Methodsmentioning

confidence: 99%

Idiopathic first seizure in adult life: who should be treated?

Donselaar

Geerts

Schimsheimer

1991

BMJ

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be managed conservatively.3" Our results suggest that not only will 16% of carcinomas be misdiagnosed but a huge burden of outpatient consultations will result if the three monthly follow up policy is adhered to. This conservative policy is also unacceptable to most patients. " The previous policy of our unit to excise all discrete lumps occurring in the under 36 age group, whatever the preoperative diagnosis, would seem to be supported by our figures. A total of 9768 patients aged under 36 with benign breast disease were seen over the 19 years. If each of these patients had had a discrete lump and had had surgical excision the operative burden would have been 10 cases a week. Tru-Cut biopsy could be used to provide tissue provided that representative samples are obtained. Most patients, however, prefer surgical excision. " Our current policy is to perform fine needle aspiration in all women with clinically discrete breast masses. Combined ultrasonography and radiography is also performed in all patients with a discrete mass. If the results of combined mammography are equivocal compression paddle radiographs are taken. As soon as the results are available the patient is reviewed in an assessment clinic. Any concern over the nature of the mass results in excision biopsy being performed (figure).We suggest that centres not possessing adequate cytological and combined mammographic facilities should excise all discrete breast masses in this age group without previous investigation. We also suggest that the poor detection rate by general practitioners warrants all young patients presenting with a breast lump being referred to a surgeon with an interest in breast disease. Idiopathic first seizure in adult life: who should be treated?Cees A van Donselaar, Ada T Geerts, Robert-Jan Schimsheimer Abstract Objective-To assess the accuracy of the diagnosis, recurrence rate, and fate after the first recurrence in adult patients with an untreated idiopathic first seizure.

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“…Some studies have been confined to children, 7,10,15,21,25,[27][28][29][30] and others have included only adults. 5,12,13,16,17,23 …”

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confidence: 99%

Factors predicting prognosis of epilepsy after presentation with seizures

et al. 2000

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The objective of this study was to identify the factors, at the time of diagnosis, that determine the prognosis for remission of epilepsy. A prospective community‐based cohort study of 792 patients recruited at the time of their first diagnosis of epileptic seizures was undertaken; in those classified 6 months after presentation, the median follow‐up period was 7.2 years (quartiles at 6.2 and 8.2 years) after presentation. We analyzed data from 6 months after the first identified seizure, which prompted the dianosis of epilepsy, to allow us to factor in those aspects contingent on a diagnostic assessment. Baseline clinical and demographic data were analyzed using the Cox proportional hazards regression model with remission of epilepsy for 1, 2, 3, and 5 years as outcome measures. The dominant clinical feature predicting remission was the number of seizures in the 6‐month diagnostic assessment period. Thus, the chance of entering 1 year of remission by 6 years for a patient who had 2 seizures during this initial 6 months was 95%; for 5 years of remission, it was 47% as opposed to 75% for 1 year of remission and 24% for 5 years of remission if there had been 10 or more seizures during this period. The number of seizures in the early phase of epilepsy (here, taken as the first 6 months after presentation) is the single most important predictive factor for both early and long‐term remission of seizures. Ann Neurol 2000;48:833–841

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Diagnostic Factors in Adult Males Following Initial Seizures

Cited by 34 publications

References 5 publications

Risk of Recurrence After an Initial Unprovoked Seizure

Risk of Recurrence After an Initial Unprovoked Seizure

Idiopathic first seizure in adult life: who should be treated?

Factors predicting prognosis of epilepsy after presentation with seizures

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