Evidence-based guideline: Management of an unprovoked first seizure in adults: Report of the Guideline Development Subcommittee of the American Academy of Neurology and the American Epilepsy Society answers\u00a0 very critical questions regarding unprovoked first seizure.<\/p>\n
<\/p>\n
1. The recurrence of<\/span> an unprovoked<\/span> first<\/span> seizure<\/span> is greatest early within the first<\/span> 2 years (21%-45%)<\/p>\n 2. Increased risk may include a prior brain insult (Level A), an EEG with epileptiform abnormalities (Level A), a significant brain-imaging abnormality (Level B), and a nocturnal seizure<\/span> (Level B).<\/p>\n 3. Immediate antiepileptic drug (AED) therapy, as compared with delay of treatment pending a second seizure<\/span>, is likely to reduce recurrence risk within the first<\/span> 2 years (Level B) but may not improve quality of life (Level C).<\/p>\n 4. Over a longer term (>3 years), immediate AED treatment is unlikely to improve prognosis as measured by sustained seizure<\/span> remission (Level B).<\/p>\n 5. Patients should be advised that risk of AED adverse events (AEs) may range from 7% to 31% (Level B) and that these AEs are likely predominantly mild and reversible.<\/p>\n <\/p>\n <\/p>\n