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P&S Journal

The P&S Journal: Spring 1998, Vol.18, No.2
Research Reports
Defining Epilepsy

Individuals who experience two or three unprovoked seizures have a high risk of suffering more seizures and should be treated for epilepsy, according to a study published in the Feb. 12, 1998, issue of New England Journal of Medicine. The study establishes the first mathematically sound definition of epilepsy.

Epilepsy, a condition that affects approximately 2.5 million Americans, is defined as a condition characterized by recurrent unprovoked seizures. "There has been a debate in the medical community about how many seizures that means and when a person should be treated for epilepsy," says lead author Dr. W. Allen Hauser, professor of neurology and public health. "This study shows that two seizures are necessary and sufficient criteria for defining epilepsy. It provides a prediction of risk of seizure recurrence for people newly diagnosed with epilepsy."

The researchers followed 204 patients for a mean of eight years, beginning at the diagnosis of their first unprovoked seizure. Only one-third of the original group had more seizures within five years. However, once patients had a second seizure, their risk of a third jumped to 73 percent. Patients who had three seizures had a 76 percent risk of a fourth.

"Once a patient has a second seizure, the risk of having a third or fourth is quite high," says Dr. Hauser. "So the implication is that patients should be treated after their second seizure." In the United States, approximately 150,000 people are diagnosed with epilepsy each year.

The study was funded in part by a grant from the National Institute of Neurological Disorders and Stroke.

copyright ©, 1996 Columbia-Presbyterian Medical Center

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