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Subject Area

Neuropsychiatry

Article Type

Original Study

Abstract

Background Recent changes in epilepsy definition included the first nonprovoked seizure with a high risk of recurrence (>60%) in the next 10 years. A single nonprovoked seizure with EEG showing epileptiform discharge carries a high risk of seizure recurrence and so is sufficient for epilepsy diagnosis. Objectives The authors investigated if EEG monitoring for a longer period (6 h) can increase the likelihood of epileptiform discharge and so predict the risk of seizure recurrence for early diagnosis, treatment, and hence better outcome for people with epilepsy in Egypt. Patients and method A nonrandomized prospective case-control study was conducted on 70 healthy volunteers and 70 adult patients with first attack of nonprovoked seizure who were recruited from Kobry El-Qobba Armed Forces Medical Complex and Menufia University Hospitals between January 2020 and June 2021. They underwent 6-h EEG, where the first 30 min were compared with the whole record, and were followed up for any epileptic event through 6 months. Results The mean age at first seizure was 25.9 ± 14.7 years. The rate of EEG abnormalities in cases was 38.6%. The seizure recurrence risk at 6 months was 32.9%. Six-h EEG had higher sensitivity than 30-min EEG in prediction of seizure recurrence (65.22% and 30.43%, respectively) with specificities of 89.36% and 7 4.47%, respectively. Overall, 22.9% of cases had abnormal neuroimaging. There was no significant association between abnormal imaging and seizure recurrence (P = 0.291). Conclusion Abnormal long-term EEG was a strong risk factor for seizure recurrence.

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