At. Berg et S. Shinnar, DO SEIZURES BEGET SEIZURES - AN ASSESSMENT OF THE CLINICAL-EVIDENCE IN HUMANS, Journal of clinical neurophysiology, 14(2), 1997, pp. 102-110
For more than a century, epilepsy was characterized as a chronic disea
se, with little chance of remission or cure. It was also considered a
progressive disease in which seizures led to more seizures. Experiment
al work in animals provided additional support for the notion that sei
zures could beget seizures. However, the earliest clinical observation
s in humans were based on highly selected, largely refractory patients
. Furthermore, the experimental work in animals bore little relation t
o naturally occurring seizures and epilepsy in humans. Evidence from m
ultiple sources regarding the nature and natural history of seizures a
nd epilepsy in humans has repeatedly demonstrated that in most cases t
he occurrence of seizures itself does not influence the long-term outc
ome of epilepsy. Consequently, interventions to prevent seizures early
in the course of a seizure disorder do not alter the natural history
of seizure disorders with respect to whether remission will occur in t
he long term. That outcome is largely predetermined by other factors,
many of which are not currently amenable to intervention. In some rare
syndromes, deterioration is progressive, In these instances, it is th
e underlying syndrome, not the seizures, that is primarily responsible
for the deterioration. In addition, extremely prolonged seizures (whi
ch are rare) may also directly cause damage. These are exceptions rath
er than, as previously believed, the rule. The available human data st
rongly suggest that seizures do not beget seizures and that epilepsy i
n humans is usually not a progressive disorder.