Cited by 213Epilepsy research and treatmentPharmacological Effects and Toxicity StudiesDiet and metabolism studies

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Practice parameter: Treatment of the child with a first unprovoked seizure: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society*

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Hirtz, D., Berg, A., Bettis, D., Camfield, C., Camfield, P., Crumrine, P., Gaillard, W. D., Schneider, S., Shinnar, S.·2003·Neurology

DOI 10.1212/01.wnl.0000033622.27961.b6

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Abstract

The Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society develop practice parameters as strategies for patient management based on analysis of evidence regarding risks and benefits. This parameter reviews published literature relevant to the decision to begin treatment after a child or adolescent experiences a first unprovoked seizure and presents evidence-based practice recommendations. Reasons why treatment may be considered are discussed. Evidence is reviewed concerning risk of recurrence as well as effect of treatment on prevention of recurrence and development of chronic epilepsy. Studies of side effects of anticonvulsants commonly used to treat seizures in children are also reviewed. Relevant articles are classified according to the Quality Standards Subcommittee classification scheme. Treatment after a first unprovoked seizure appears to decrease the risk of a second seizure, but there are few data from studies involving only children. There appears to be no benefit of treatment with regard to the prognosis for long-term seizure remission. Antiepileptic drugs (AED) carry risks of side effects that are particularly important in children. The decision as to whether or not to treat children and adolescents who have experienced a first unprovoked seizure must be based on a risk-benefit assessment that weighs the risk of having another seizure against the risk of chronic AED therapy. The decision should be individualized and take into account both medical issues and patient and family preference.

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Authors: Hirtz, D., Berg, A., Bettis, D., Camfield, C., Camfield, P., Crumrine, P., Gaillard, W. D., Schneider, S., & Shinnar, S.
Affiliations: Northern Illinois University (US)
ORCID: Berg, A.
Gaillard, W. D.
Shinnar, S.
Venue: Neurology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2003-01-28
Volume: 60
Issue: 2
Pages: 166-175
ISSN: 0028-3878 (ISSN-L)
1526-632X
DOI: 10.1212/01.wnl.0000033622.27961.b6
OpenAlex: W2092769108
Cited by: 213
References: 67
Citations by year: 2026: 4 · 2025: 8 · 2024: 5 · 2023: 4 · 2022: 9 · 2021: 11 · 2020: 6 · 2019: 9 · 2018: 7 · 2017: 7 · 2016: 6 · 2015: 12 · 2014: 6 · 2013: 6 · 2012: 10
FWCI: 8.67
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Neurology (publishedVersion)
PubMed (publishedVersion)
Funders: American Epilepsy Society
American Academy of Neurology
Epilepsy Society
Topics: Health Sciences › Medicine › Clinical Neurology › Epilepsy research and treatment
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
Health Sciences › Medicine › Physiology (medical) › Diet and metabolism studies
Keywords: first unprovoked seizure, pediatric epilepsy, antiepileptic drugs, seizure recurrence, chronic epilepsy, anticonvulsant adverse effects, risk-benefit assessment, seizure prevention, children and adolescents, seizure remission
MeSH terms: Adolescent, Adult, Anticonvulsants, Behavior, Child, Child, Preschool, Clinical Trials as Topic, Cognition, Drug Eruptions, Follow-Up Studies, Humans, Prognosis, Remission Induction, Seizures, Sleep Stages, United States, Cohort Studies, Treatment Outcome, Risk Assessment, Secondary Prevention

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Practice parameter: Treatment of the child with a first unprovoked seizure: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society*

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