At age 15 months, this previously healthy girl presented with an unprovoked seizure with right-sided clonic movements and facial twitching for 8 minutes. Serial MRIs revealed evolution from diffusion-weighted changes suggestive of edema to left hippocampal hyperintensity on T2 images and subsequently atrophy suggestive of mesial temporal sclerosis (MTS)1 (figures 1 and 2). After seizure freedom...

A seizure is a clinical manifestation of presumed or proved abnormal electrical activity in the brain. A first seizure can range from a fleeting subjective experience such as déjà vu or a twitch (myoclonic jerk) through to a tonic-clonic convulsion. Some seizuremanifestations overlap with normal phenomena. A single seizure may be provoked (with an acute precipitant that may or may not recur) or...

PURPOSE To synthesize evidence concerning the effect of antiepileptic drugs (AEDs) for seizure prevention and to contrast their effectiveness for provoked versus unprovoked seizures. METHODS Medline, Embase, and The Cochrane Clinical Trials Register were the primary sources of trials, but all trials found were included. Minimal requirements: seizure-prevention outcome given as fraction of cas...

PURPOSE To investigate response to sequential treatment schedules and risk of development of refractory epilepsy in childhood. METHODS All children younger than 14 years with two or more unprovoked seizures seen at our hospital between 1994 and 2004 were included and prospectively followed. "Seizure control" was defined as a 2-year seizure-free interval without further recurrences except thos...

We followed 208 patients identified on the day of their 1st unprovoked seizure for a mean duration of 4 years. Seizures recurred in 64. Recurrence risks were estimated to be 14%, 29%, and 34% at 1, 3, and 5 years following the 1st episode. A history of previous neurologic insult (remote symptomatic) was associated with a 2.5-fold increased risk of recurrence. Among idiopathic cases, a sibling w...

M e t h o d s Design: Randomized controlled trial (Standard and New Antiepileptic Drugs [SANAD] trial, Arm B). Allocation: Concealed.* Blinding: Unblinded.* Follow-up period: Up to 6 years. Setting: Hospital-based outpatient clinics in the United Kingdom. Patients: 716 patients (mean age 23 y, 60% men) who had ≥ 2 clinically definite, unprovoked epileptic seizures in the past year and were reco...

OBJECTIVE To assess the accuracy of the diagnosis of a first unprovoked seizure in childhood, the recurrence rate within two years, the risk factors for recurrence, and the long term outcome two years after recurrence. METHODS One hundred and fifty six children aged 1 month to 16 years after a first seizure, and 51 children with a single disputable event were followed up. The diagnosis of a s...

Understanding neural network behavior is essential to shed light on epileptogenesis and seizure propagation. The interconnectivity and plasticity of mammalian limbic and neocortical brain regions provide the substrate for the hypersynchrony and hyperexcitability associated with seizure activity. Recurrent unprovoked seizures are the hallmark of epilepsy, and limbic epilepsy is the most common t...

Epilepsy is a group of disorder characterized by two or more unprovoked seizures. The estimated average prevalence of epilepsy in US is 6.8 per 1000, Europe is 5.5 per 1000, and Asia is 1.5 to 14 per 1000 people respectively. [1] Epilepsy is classified based on the source of seizure into partial and generalized seizures. [1] About 2/3rd of newly diagnosed epilepsies are partial or secondarily g...