The American Academy of Neurology and the American Epilepsy Society have released new guidelines on managing unprovoked first seizure in adults. The guidelines, published in Neurology, include the following: Clinicians should counsel patients with unprovoked first seizure that the risk for recurrent seizure is highest within the first 2 years (21–45%). The following factors increase the risk for recurrence: previous brain injury (e.g., through stroke or trauma), EEG with epileptiform abnormality, significant abnormalities on brain imaging, and nocturnal seizure.
Immediate treatment with antiepileptic drugs (AEDs) is associated with reduction of seizure recurrence in the first 2 years, compared with delaying treatment until a second seizure occurs. However, quality of life may not be improved with immediate treatment. Immediate therapy isn't likely to improve the chances of long-term…
