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May 1988

Should People Be Treated After a First Seizure?

Author Affiliations

Department of Neurology Kings College Hospital Denmark Hill London, SE5 9RS, England

Arch Neurol. 1988;45(5):490-491. doi:10.1001/archneur.1988.00520290016003

To the Editor.  —May we comment on the controversy between Hauser1 and Hart and Easton2 on the subject of seizure recurrence after a first unprovoked seizure and the implications for treatment, as much of the debate centers on our own study?3In his figure, Hauser1 compares our3 high (71%) recurrence rate after a single seizure with the moderate (55%) and low (27%) three-year recurrence rates in the studies by himself and his colleagues at Rochester, Minn,4 and Minneapolis,5 respectively. There are many possible explanations for the variation in these three (and other2) studies, but two factors appear most important to us. First, in both the Rochester and Minneapolis studies, approximately two thirds of the patients were actually treated with anticonvulsants, whereas none of our patients were so treated. This is very likely to have reduced the overall recurrence rate in the American studies. It

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