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Early Treatment of a Single Generalized Tonic-Clonic Seizure to Prevent Recurrence
Ronit Gilad, MD;
Yair Lampl, MD;
Uri Gabbay, MD;
Yehiel Eshel, MD;
Ida Sarova-Pinhas, MD
Arch Neurol. 1996;53(11):1149-1152.
Abstract
Background
The question of whether to start antiepileptic treatment after a single unprovoked seizure remains controversial and has been the subject of much debate in the relevant literature.
Objectives
To determine the rate of recurrence of a second attack after a single unprovoked epileptic seizure by using 2 study groups of treated and untreated patients and, thus, to establish a treatment policy for these patients.
Patients and Methods
A group of 91 patients with a single generalized tonic-clonic seizure were prospectively studied; 87 of these patients completed the study. The end point of the study was 36 months after the single attack or the occurrence of a subsequent epileptic attack. The patients were randomly divided into 2 groups: 45 patients who immediately received anticonvulsive treatment and 42 who remained untreated for the follow-up period. Patients in the treated group were given monotherapy with carbamazepine. The results of recurrences were statistically analyzed by using the Kaplan-Meier method.
Results
Results indicated a significantly higher percentage of seizure-free patients in the treated group compared with that in the untreated group (P=.001). The treated men were proved to be less at risk for recurrent seizures compared with treated women (P<.001 vs P=.03, respectively).
Conclusion
Treatment after a single unprovoked seizure leads to a significant reduction in the risk of relapse of generalized tonic-clonic epilepsy.
Author Affiliations
From the Department of Neurology, The Edith Wolfson Medical Center, Holon, Israel (Drs Gilad, Lampl, Eshel, and Sarova-Pinhas); the Gerti Institute of Statistics, Sheba Medical Center, Tel Hashomer, Israel (Dr Gabbay); and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Drs Gilad, Lampl, Eshel, and Sarova-Pinhas).
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