Seizures Health Article

Prognosis

About 30% of patients with severe seizures (starting in early childhood), continue to have attacks and usually never achieve a remission state. In the United States, the prevalence of treatment-resistant seizures is about one to two per 1,000 persons. About 60–70% of persons achieve a five-year remission within 10 years of initial diagnosis. Approximately half of these patients become seizure-free. Usually the prognosis is better if seizures can be controlled by one medication, the frequency of seizures decreases, and there is a normal EEG and neurological examination prior to medication cessation.

People affected by seizure have increased death rates compared with the general population. Patients who have seizures of unknown cause have an increased chance of dying due to accidents (primarily drowning). Other causes of seizure-associated death include abnormal heart rhythms, water in the lungs, or heart attack.

Prevention

There are no gold standard recommendations for prevention, since seizures can be caused by genetic factors, blood abnormalities, many medications, illicit drugs, infection, neurologic conditions, and other systemic diseases. If a person has had a previous attack or has a genetic propensity, care is advised when receiving medical treatment or if diagnosed with an illness correlated with possible seizure development.

BOOKS

Goetz, Christopher G. Textbook of Clinical Neurology. 1st edition. Philadelphia: W. B. Saunders Company, 1999.

Goldman, Lee, and others. Cecil Textbook of Medicine. 21st edition. Philadelphia: W. B. Saunders Company, 2000.

Goroll, Allan H. Primary Care Medicine. 4th edition. Philadelphia: Lippincott Williams and Wilkins, 2000.

PERIODICALS

Dodrill, C. R., C. G. Matthew. "The role of Neuropsychology in the Assessment and Treatment of Persons with Epilepsy." American Psychologist (September 1992).

ORGANIZATIONS

Epilepsy Foundation. 4351 Garden City Drive, Landover, MD 20785-7223. (800) 332-1000. <http://www.efa.org>.

Laith Farid Gulli, MD

Alfredo Mori, MD, FACEM