-2384 2 *. : 4 :. 2 / 4 3 6/. ( /) : 6 /4. 6. 00 92 6. 0 :. :. 0 :. International league Against Epilepsy (ILAE) First Unprovoked Seizure (FUS) 24 () (2) 20.. 2 3-4. (). : -* - 0 626024: 0 626024 : E-mial: sinaloo@sums.ac.ir - -2 84// : 83//20 :
. 4 : ). (2 9) 24.. :. ). Remote Symptomatic * (3).. : * Remote Symptomatic. ().. 0. 2 806 0 (6 8 9). 30 ( 0)..... 39 (Unprovoked) 38 20 200. 3. 4 384
. ( ) 4 6/02 ± 4/29 3 2 ( ). 6. 36 2 9 20/2 ± /4 33 2 00 24 2/3 ± /9. 9/2 ± 6/8-2/4 3/8 40 24/8 3 20 8 36 34/2 2/8 3/ / 24 9 26 9/3 4/ 42/ 33/3 32 2 < 3 > 3 < 0 > 0 ( 80) 6 4 ( ( 6/6) 3/4) 24.. 69 2 ( /). ( 4) /4 ± /. 24 9 ( 22) 33. 4 ( 2) 3 ( 6/2). 33 ( 24) 8 8 6 ( 44) 2 (8) 6 2 6 ( 24) 24 () 92.. 24 ) 24 (Todd) postictal (. MRI. : () MRI... 382. 24. : 2. 2 (Kaplan- Meier Survival analysis). Cox s proportional P<0.0 Hazard. ( 49) 4 384
(3 2). : provoked 24 postictal. :2 P value 0/3 0/40 0/029 * -- 0/2 -- 0/9 0/069 0/322 0/29 0/93 0/69 0/882 0/026* 0/ 0/692 0/96 0/2 0/632 0/683 0/22 (Multivariable analysis using Cox) 9 % CI lower upper 0/23-6/03 0/88-/409 /-/326 -- 0/94-2/42 -- 0/6-2/088 0/998-/063 0/363-/39 0/3-/4 0/296-3/639 0/00-/84 0/339-3/28 /0-2/9 0/99-2/8 0/2-3/486 0/20-4/6 0/8-3/46 0/289-2/23 0/639 -/98 0/42 -/229 Rate ratio 2/0 2/064 2/83 /00 /388 /00 /0 /030 0/2 0/669 /038 0/890 /093 /9 /309 0/29 0/96 /26 0/84 /2 0/8 * Statistically significant () 3 0 3 0 (4) 24 postictal Remote symptomatic provoked Reference category 2 4 3 66/ Follow up (mount) (). : ( ) 2 Remote symptomatic seizure Idiopatihic seizure 26 :2 2 9 ) (Proportionate hazard). 0 384
-3 /03 48/9 80 6/ 3 4/3 8/6 2/4 2/ 30/3 3/ / 3/8 / 4/8 8/6 8/2 3/ ¼ / 9/6 32/4 8/6 3/4 4 6 24 60 8 0 40 44 9 2 4 2 9 6 6 22 4 4 8 3 4 8 4/6 4 44 6 80 20 30 8 4 4 9/3 8 84 9/3 6/6 4/6 6/6 2/3 6/6 3/3 0/6 4 40 3 6 3 33 42 60 23 4 3 3 6 63 6 28 38 3 () 48 2 8 8/ 2/8 38/ 6/ 64/3 3/ 30 62/8 30 / / 2/8 / 20 / /4 8/ 2/8 2/ 6/ 2/8 34 2 3 2 2 43 4 2 2 44 2 4 4 6 9 9 4 2 24 24 Postictal provoked ( /9). 44 69 ( 30) 2 ( 62/8) ( /) 4 69 ( 4 ) 3 ( 4) 3 ( 9/3). (8) 6. 4/3 Remote Symptomatic ( ( 3/) 86/8) 9 26 3/ Remote Symptomatic 48/4.(2) (P=0/04) 38 ( /0) 6 ( 36/9) 384
Boulloche Shinnar (2 4 ). 22/6 3 4 3 6 6/. / 46 6 40) Stroink (3). ( 4 /4 ± / (9 3)..( 92) ( 49) 4/) FUS ( 49/3 (9 6). 0 3 (2 6). ( 80) 64 Shinnar. (9). (%20) 36 9/6. 63/6.(P=/008) Cox hazard (9% /4. contidance interval) ( /) 22 ( 8/) 6 ( 2/3) 6 2/ 48..(p= 0/032) ( 8/6) 8 4 ( ) 38 ( 6/) (0/6) 44/. 6/.(p=0/044) 9 86/8) 26 ( 3/) Remote Symptomatic ( Remote Symptomatic ( 6) Shinnar 4 3 2. ( 84) / (2 6 ). /8 ( /8) Comfield 2 (6 3) ( 4) Hans Stroink 384
. ( 0 ) 9/ (Cox ). 0/ Stroink. (6). 6 0. 22 (8 6) 0 FUS Shinnar. Remote Symptomatic 3 0 3 3 (2).. (Remote Symptomatic) 48/4 (p=0/04) 3/ (2) 68 3 Shinnar (6). 4 0 Stroink. (84). Shinnar (Remote. Symptomatic seizure) (2). Hauser (). Stroink (3). 9 44/3 63 30 FUS (6 9). 63/6 4/3 9/6 Stroink. (6) Shinnar. 40 42 ) 2 (. 32 4/3 (2 ) (9 20 2). 60/3 384
( 3/. Shinnar (9 2). : 44/ FUS 4 ( 2) 3.. 0. References. John H. Menkes and Raman Snaker. Text book of Child Neurology 6th ed. 2000: 99-00. 2. Commission on Epidemiology and prognosis. International league Against Epilepsy Guidelines for epidemiologic studies on epilepsy. Epilepsia 34 : (993) 92-96. 3. Annegers JF, Shirts SB, Hauser WA, Kurland LT: Risk of recurrence after on initial unprovoked seizure. Epilepsia 2: (986) 43-0. 4. Berg AT, Shinnar S: The risk of recurrence following a first unprovoked seizure: A quantitative review. Neurology 4: (99) 96-92.. Camfield PR, Camfield CS, Dooley JM, Tibbles JAR, Fung T, Garner B: A randomized study of carbamazepin versus no medication following a 6/ (p =/044). Provoked. Postictal 24 /) first unprovoked seizure in childhood. Neurology 39: (989) 8-82. 6. Camfield PR, Camfield CS, Dooley JM, Tibbles JAR, Fung T, Garner B: Epilepsy after a first unprovoked seizure in childhood. Neurology 3 : (98) 6-666.. Hauser WA, Anderson VE, Loewenson RB, MC Roberts SM: Seizure recurrence after a first unprovoked seizure. N Eng J Med 30: (982) 22-28. 8. Hopkins A, Garman A, Clarke C: The first seizure in adult life : value of clinical features electroencephalography and computerized tomographic scanning in prediction of seizure recurrence. Lancet : (988) 2-26. 9. Shinnar, S, Berg AT, Moshe SL, Petix M, 384
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