Epidemiology / NOS Genetic seizure disorders

Question 1

Rate of seizure recurrence after 1st unprovoked seizure:
- All-comers, without intervention
- With normal EEG and normal neurological status (1 year)
- With normal EEG and normal neurological status (2 year)normal EEG and normal neurological status (3 year)

Answer 1

Rate of seizure recurrence after 1st unprovoked seizure:
- All-comers, without intervention: 40-50%
- With normal EEG and normal neurological status (1 year) - 20%
- With normal EEG and normal neurological status (2 year)- 25%
- normal EEG and normal neurological status (3 year) - 30%

Question 2

Factors increasing risk of epilepsy with first unprovoked seizure

Answer 2

status epilepticus, but specifically in patients with remote history of symptomatic seizures (not all)

Question 3

Childhood Absence Epilepsy (CAE)
- Males vs Females
- Onset

Answer 3

Childhood Absence Epilepsy (CAE)
- Female > Males
- Onset 4-8 years

Question 4

Juvenile Absence Epilepsy (JAE):
- Males vs Females
- Onset
- How seizures clinically differ from CAE (4)

Answer 4

Juvenile Absence Epilepsy (JAE):
- Males vs Females: No clear preference
- Onset: 9-13 years
- How seizures clinically differ from CAE (4)
- Clusters upon waking
- Less Frequent
-0 ocular / retropulsive movements less often seen
- 80% also have GTC or Myoclonic seizures

Question 5

Myoclonic absences
- Age of onset
- Males vs Females
- Development

Answer 5

Myoclonic absences
- Age of onset: around 7
- Males > Females
- Development: delayed in 2/3 of patients

Question 6

Factors that increase risk of recurrence in febrile seizures (3)

Answer 6

• Temperature low at time of onset
• younger children
• increased illness frequency

Question 7

Incidence of Status epilepticus in USA

Answer 7

18 out of 100,000

Question 8

Risk of SUDEP:
Drug resistant epilepsy patients
Non-drug resistant Epilepsy

Answer 8

Drug resistant epilepsy: 1/100
Non-drug resistant: 1/1000

Question 9

% of US population with:
- Epilepsy
- History of seizure sometime in life

Answer 9

Epilepsy: 3.1%
history of at least 1 seizure: 5%

Question 10

Epilepsy Statistics - Incidence rate for:
- Epilepsy
- 1st time unprovoked seizure
- acute symptomatic seizures
- all seizures (epilepsy and non-epilepsy)

Answer 10

Epilepsy: 44 / 100,000
1st time unprovoked: 61/100,000
Acute symptomatic: 39/100,000
All seizures: 100/100,000

Question 11

Seizure recurrence rate after
- first unprovoked seizure
- two unprovoked seizure
- three unprovoked seizures
- after treating first unprovoked seizure

Answer 11

• first unprovoked seizure: 40%
• two unprovoked seizure: 73%
• three unprovoked seizures: 76%
• after treating first unprovoked seizure: 15%

Question 12

Seizure recurrence after first seizure + modifiers
Etiology:
- Idiopathic
- Symptomatic
EEG
- Normal
- Epileptiform
Etiology + EEG
- Idiopathic and normal
- Symptomatic and abnormal

Answer 12

Etiology:
- Idiopathic: 32%
- Symptomatic: 57%
EEG
- Normal: 27%
- Epileptiform: 58%
Etiology + EEG
- Idiopathic and normal: 24%
- Symptomatic and abnormal: 65%

Question 13

Seizure recurrence after first seizure + modifiers
- Focal vs Generalized
- Time of day
- duration / Timing (2)

Answer 13

Focal onset > generalized
More common if seizure was at night
More common if presents in status or with clusters of seizures at onset

Question 14

Seizure recurrence after first SYMPTOMATIC seizure based on cause, acute (<1 week) and remote (>1 week)
- Stroke
- TBI
- CNS infection

Answer 14

Stroke: A= 33% R =71.5%
TBI: A = 13.4% R = 46.6
CNS infection: A=16.6%, R=63.5%

Question 15

Answer 15

Question 16

Epilepsy statistics:
Total estimated people worldwide with epilepsy

Answer 16

40 million

Question 17

Epilepsy statistics:
Worldwide mortality from epilepsy:

Answer 17

0.2%

Question 18

Small pedantic criteria from ILAE regarding “seizure Free” status

Answer 18

Must be 3 times the pretreatment interseizure interval

Question 19

Percentage of patients who will become seizure free for one year after
- first AED
- Second AED
- third AED

Answer 19

1st: 47%
2nd/3rd: 14%

Question 20

ILAE criteria for which seizure is resolved (2)

Answer 20

1) past age-range of age-dependent epilepsy syndrome
2) remained seizure free for 10 years and off meds for 5 years

Question 21

ADHD and Epilepsy:
How much more common is it than in the general population?
Prevelance in children with Epilepsy

Question 22

Incidence of status epilepticus

Answer 22

7-41 cases per 100,000

Question 23

Status epilepticus, peak incidence (2)

Answer 23

before age 1 and after 60 years