Peer-reviewed article
Electroencephalographic profile and its association with seizure recurrence in children with a first unprovoked seizure: a prospective observational study from Eastern India
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Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This single-centre study followed 176 neurologically and developmentally normal children aged 1-18 years who came to a hospital in Kolkata with a first unprovoked seizure. All had an EEG within 24 hours and a brain MRI. About 58% had an abnormal EEG. Of the 160 children followed for three months, 45% had another seizure, and this was more common in children with an abnormal EEG or focal seizures. The authors conclude that EEG is useful for judging the risk of early recurrence.
Key points
- Mean age was 6.8 years, and 60.2% of the children were male.
- Generalized seizures occurred in 61.4% and focal seizures in 38.6%.
- An abnormal EEG was found in 58.0% of children, and 79.4% of these showed epileptiform discharges.
- Seizures recurred within three months in 45.0% of the 160 children who completed follow-up.
- Recurrence was higher with an abnormal EEG (58.5% vs 25.8%; p<0.001) and with focal seizures (54.8% vs 38.8%; p=0.047).
Limitations
The study was done at one tertiary hospital in Kolkata with a three-month follow-up, so it cannot show longer-term recurrence or whether results apply elsewhere. Only chi-square tests are described, so the abstract does not show whether other factors were adjusted for. It does not evaluate an intervention.
Abstract
Background: A first unprovoked seizure is a common neurological presentation in childhood, and the electroencephalogram (EEG) is recommended as a key investigation in its evaluation.Data on the EEG profile of such children from Eastern India and its relationship with early seizure recurrence remain limited.This study aimed to evaluate the seizure semiology and EEG findings in neurologically normal children presenting with a first unprovoked seizure and to determine their association with recurrence within three months.Methods: This single-centre, prospective, observational study enrolled 176 neurologically and developmentally normal children aged 1-18 years presenting with a first unprovoked seizure to a tertiary care hospital in Kolkata between May 2022 and April 2023.All children underwent EEG within 24 hours of the seizure and magnetic resonance imaging (MRI) of the brain.Participants were followed up for three months to detect seizure recurrence.Associations were tested using the chi-square test, with p<0.05 considered significant.Results: The mean age was 6.8 (±4.9) years with a male preponderance (60.2%;M:F 1.4:1).Generalized seizures occurred in 61.4% and focal seizures in 38.6% of children.An abnormal EEG was found in 58.0%, of which 79.4% showed epileptiform discharges.Among the 160 children (90.9%) who completed follow-up, seizure recurred in 45.0%.Recurrence was significantly higher in children with an abnormal EEG (58.5% vs 25.8%; p<0.001) and with focal seizure semiology (54.8% vs 38.8%; p=0.047).Conclusion: An abnormal EEG was present in more than half of children after a first unprovoked seizure and was the strongest predictor of early recurrence.EEG, particularly when combining awake and sleep recordings, is a valuable tool for risk stratification in this population.