Seizure recurrence after a first unprovoked seizure: With and without treatment

BACKGROUND: Most of the studies have shown that approximately one third of patients with single seizure will experience a second one. Data regarding seizure-free survival time and recurrence rate vary widely. We investigated the likelihood of a second attack and seizure-free survival time with and without early treatment in our epileptic patients. METHODS: Patients of the first unprovoked seizures were recruited between 2000-2005 years. They were randomized into two groups: one treated with carbamazepine and the other was not treated. After obtaining a written consent, all patients were followed up for a second seizure for a period ranging from 12 to 36 (19.1 ± 5) months. RESULTS: A total number of 150 patients were enrolled in this study, of which 13 patients were lost to follow up. The remaining patients (71 males and 66 females) were followed up during 5 years. They were randomized into two groups: treatment (50 patients) and non-treatment (87 patients); 30.2% of all patients were without relapsing, of which 48.9% were on treatment (case) and 19.5% did not receive any treatment (the control group). The mean seizure-free survival times were 6 months and 3.8 months in the treated and non-treated patients, respectively (P = 0.017). CONCLUSIONS: We found strong correlation between relapse and treatment started after the first attack (P 0.05); i.e., the patients who received treatment in their first attack may be at lower risk of relapsing.