Risk factors for 5-year recurrence of spontaneous symptomatic epileptic seizures in infants and young children

Abstract:

Objective To investigate the recurrence rate and risk factors of spontaneous symptomatic epileptic seizures after the first episode in infants and young children. Methods The clinical data of infants and young children who experienced the first episode of spontaneous symptomatic epileptic seizures between April 2009 and April 2011 in Suzhou Children's Hospital were collected. Follow-up visits were performed once every 1-3 months, and the followup time was 1-60 months. The Kaplan-Meier method and Cox proportional hazards model were applied to calculate the recurrence rate of spontaneous symptomatic epileptic seizures and analyze the risk factors for seizure recurrence. Results Sixty-three children experiencing a first episode of spontaneous symptomatic epileptic seizures were enrolled. Within 5 years after the first episode, 43 children experienced the recurrence of spontaneous symptomatic epileptic seizures, with a 5-year cumulative recurrence rate of 69.4%. Among all recurrent cases, 86% experienced recurrence within 1 year after the first episode. The multivariate analysis with the Cox proportional hazards model showed that epileptiform discharges on electroencephalography were the independent risk factor for recurrence of spontaneous symptomatic epileptic seizures (HR=5.349, 95%CI: 2.375-12.048). Conclusions The recurrence rate of spontaneous symptomatic epileptic seizures after the first episode is high in infants and young children. Epileptiform discharges on electroencephalography are the independent risk factor for the recurrence, and thus it is suggested to perform antiepileptic therapy for these children.