Recurrence after a first untreated seizure in the Hong Kong Chinese population

Purpose: There is wide variation in the reported prognosis after a first un provoked generalized tonic-clonic convulsion and in the risk factors that a re associated with recurrence, Estimates for the risk of recurrence range f rom 26 to 71%. We investigated the likelihood of a second attack in Hong Ko ng Chinese patients. Methods: One hundred thirty-two patients with a first convulsion that was u nexplained by acute neurological or medical causes were retrospectively asc ertained. Patients' demographic details, potential risk factors for recurre nce, and current seizure status were recorded. Survival analysis was perfor med using the Kaplan-Meier procedure. Results: The cumulative probability of a second attack at 1, 2, 3, and 4 ye ars was 30, 37, 42, and 47%, respectively. Seizures in patients with abnorm al computer tomography scans of the brain were associated with an increased risk of recurrence on multivariate analysis. Conclusions: Thirty percent of the sample population experienced a second s eizure after 1 year. An additional 17% continue to be at risk of a second c onvulsion during the next 3 years.