Purpose: We describe first unprovoked seizures and newly diagnosed epilepsi
es at initial presentation, with a special emphasis on epilepsy syndromes,
in a large cohort recruited in the mid-1990s in France.
Methods: The French Foundation for Research on Epilepsy set up a network to
conduct a prospective study of patients with newly diagnosed unprovoked se
izures. Information was provided by 243 child or adult neurologists. Four n
eurologists classified each case according to the International League Agai
nst Epilepsy (ILAE) criteria, First-seizure patients and patients with prev
iously undiagnosed seizures were compared.
Results: Between May 1, 1995, and June 30, 1996, 1,942 patients aged from 1
month to 95 years were identified: 926 (47.7%) with a single seizure and 1
,016 (52.3%) with newly diagnosed epilepsy. All but 17 patients had EEGs. I
n the first-seizure and newly-diagnosed-epilepsy groups, neuroimaging studi
es were performed in 78.2 and 68.3% of patients, and medication prescribed
in 54.1 and 89.6%. respectively. There were significant differences between
the two groups with respect to age at onset and diagnosis, sex, etiology,
several specific syndromes, as well as the type and presentation of initial
seizure. In patients For whom the first seizure was convulsive, only sex,
multiple seizures in a day or status epilepticus, and cryptogenic localizat
ion-related syndrome differed between the two groups.
Conclusions. Approximately half of patients who first came to attention for
an unprovoked seizure already met epidemiologic criteria for epilepsy. The
re were significant differences between the types of patients with a first
seizure and those with newly diagnosed epilepsy. One or several seizures at
diagnosis did not influence the diagnostic assessment of the patients but
had a strong influence on the initiation of treatment.