Appendix A: Summary of Evidence-Based Guideline for Clinicians: Management of an Unprovoked First Seizure in Adults.
نویسندگان
چکیده
of the Clinical Problem Approximately150000adultspresenteachyearwithanunprovoked first seizure in theUnited States, although less thanhalf have a readilyapparentcause.1 It is important todistinguishseizures fromevents that canmimic epilepsy, such as syncope,movement disorders, and toxic-metabolicencephalopathy,andrecongizethat transient factors that temporarily lowerseizurethreshold inanotherwisenormalbrain do not establish a diagnosis of epilepsy.2 Seizures can cause serious physical,psychological,andsocialconsequencessuchasbodily injury, anxiety, lossofdrivingprivileges, limitationsonemployment,andoccasionallyevendeath.Forapatientwithanunprovoked first seizure, theriskofseizurerecurrenceposesmajorconcernsandraisesthequestion ofwhether immediateAED therapy is advisable. It is generally accepted that patients who have experienced 2 unprovoked seizures should be treatedwithAEDs because the risk of additional seizures is fairly high (57%by 1 year; 73%by4years).3 However, whether to treat a patient with a first unprovoked seizureor towaituntil a secondseizurehasbeencontroversial.Thenew guideline provides evidence-based recommendations for evaluatingandmanagingadults after a firstunprovokedseizureand forpreventing recurrences throughuseofAEDs.4A separate 2012UKNational Institute for Health and Care Excellence guideline has addressed these issues in both adults and children.5
منابع مشابه
Evidence-based guideline: Management of an unprovoked first seizure in adults: Report of the Guideline Development Subcommittee of the American Academy of Neurology and the American Epilepsy Society.
OBJECTIVE To provide evidence-based recommendations for treatment of adults with an unprovoked first seizure. METHODS We defined relevant questions and systematically reviewed published studies according to the American Academy of Neurology's classification of evidence criteria; we based recommendations on evidence level. RESULTS AND RECOMMENDATIONS Adults with an unprovoked first seizure s...
متن کاملExcessive testing in emergent evaluation of children with first unprovoked seizure
Abstract Backround: The first episode of an afebrile seizure is a common cause of admission of children to emergency departments. Alot of tests are routinely performed for these patients. The cost of such an evaluation is high and benefits are doubtful. We conducted this study in order to evaluate the results of the tests and find out what tests are necessary for children with first unp...
متن کاملAppendix B: AAN Summary of Evidence-Based Guideline for Clinicians: Management Issues for Women With Epilepsy--Focus on Pregnancy: Obstetrical Complications and Change in Seizure Frequency.
متن کامل
APPENDIX A: AAN Summary of Evidence-Based Guideline for Clinicians: Evaluating an Apparent Unprovoked First Seizure in Adults.
A 52 year old woman is brought to the emergency room after a witnessed seizure. She was shopping at the local mall when she was noted to fall to the ground suddenly and begin shaking her arms and legs. She had tongue biting and urinary incontinence. The episode lasted for 2 minutes. 911 was called and EMS arrived on the scene. The patient had stopped shaking though was confused. She was transpo...
متن کاملPractice Parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society.
OBJECTIVE The Quality Standards Subcommittee of the American Academy of Neurology develops practice parameters as strategies for patient care based on analysis of evidence. For this practice parameter the authors reviewed available evidence relevant to evaluating adults presenting with an apparent unprovoked first seizure. METHODS Relevant questions were defined and addressed by multiple sear...
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عنوان ژورنال:
- JAMA
دوره 316 15 شماره
صفحات -
تاریخ انتشار 2016