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Press Release
EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, MONDAY, APRIL 20, 2015
Media Contacts:
Rachel Seroka, [email protected], (612) 928-6129
Michelle Uher, [email protected], (612) 928-6120
Natalie Judd, [email protected], (203) 605-9515
New Guideline on How to Treat the One in 10 Who Experience a First Seizure
WASHINGTON, DC – In order to help doctors treat the millions of people who experience their
first seizure each year, the American Academy of Neurology and the American Epilepsy Society
have released a new guideline on how to treat a first seizure. The guideline is published in the
April 21, 2015, print issue of Neurology®, the medical journal of the American Academy of
Neurology (AAN), and will be presented at the AAN Annual Meeting in Washington, DC, April
18-25, 2015, which is the world’s largest gathering of neurologists.
One in 10 people worldwide have a first seizure in their lifetime. According to The International
League Against Epilepsy, epilepsy is defined as one or more seizures with a high likelihood of
recurrence, not due to another immediately triggering cause, such as low blood sugar.
The guideline, which reviewed all available evidence, found that taking epilepsy drugs
immediately after a first seizure may reduce the risk of having another seizure. The decision to
treat after a first seizure is complex because doctors must consider the risks and benefits for each
individual patient.
“This is a valuable new guideline that could change the approach many doctors take to treating a
first seizure and could improve patients’ lives,” said guideline author Allan Krumholz, MD, with
University of Maryland School of Medicine and Fellow of the American Academy of Neurology.
“About 150,000 adults have an unprovoked first seizure in the United States each year. Even one
seizure is traumatic and affects a person’s life in many social ways, such as driving a car,
employment options, falling risks and the fear of having another seizure in public. This guideline
clarifies when risk factors put individuals at greater risk.”
Seizures that are “unprovoked” happen for no immediately known reason. According to the
Institute of Medicine, one in 26 Americans will develop epilepsy in their lifetime.
The guideline shows there is strong evidence that for adults who have had a first seizure, the risk
of another seizure is greatest within the first two years. The risk ranges from about a one-in-five
chance, or 21 percent, to nearly a one-in-two chance, or 45 percent.
The guideline also found strong evidence that the risk of a second seizure is greatest in people
with a previous brain problem, such as head injury, stroke, or brain tumor and in those with an
EEG test result that shows signs of epilepsy. The analysis shows moderate evidence that the risk
is greatest in people with a significant abnormality on imaging tests of the brain and in those who
had a seizure during sleep.
Press Release
The guideline found moderate evidence that immediate treatment with an epilepsy drug can lower
this risk.
However, moderate evidence also shows that over the longer term of more than three years,
immediate treatment with an epilepsy drug, rather than waiting for another seizure before treating,
is unlikely to increase or decrease the likelihood of long-term improvement or seizure freedom.
The guideline notes that aside from affecting lifestyle choices, epilepsy drugs carry risks of side
effects ranging from seven to 31 percent.
“This guideline does not give a simple, black-and-white recommendation whether an adult should
immediately be started on an epilepsy drug,” said Jacqueline French, MD, with the New York
University Langone Comprehensive Epilepsy Center and Fellow with the American Academy of
Neurology. “What is most important is that the decision whether to immediately treat a first
seizure requires meaningful conversation between patient and doctor so that the patient’s
individual circumstances, balance of risks and benefits, and personal preferences are understood
and accounted for.”
The guideline was endorsed by the American Neurological Association and the World Federation
of Neurology.
The guideline was supported by the American Academy of Neurology.
To learn more about epilepsy, please visit www.aan.com/patients.
The American Academy of Neurology, an association of 28,000 neurologists and neuroscience
professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A
neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of
the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis,
brain injury, Parkinson’s disease and epilepsy.
The American Epilepsy Society (AES) is a non-profit medical and scientific society. Our
individual members are professionals engaged in both research and clinical care for people with
epilepsy from private practice, academia and government. For nearly 80 years, AES has been
unlocking the potential of the clinical and research community by creating a dynamic global
forum where professionals can share, learn and grow. AES champions the use of sound science
and clinical care through the exchange of knowledge, by providing education and by furthering
the advancement of the profession.
For more information about the American Academy of Neurology, visit http://www.aan.com or
find us on Facebook, Twitter, Google+ and YouTube.
Editor’s Note:
Drs. Krumholz and French will present their findings at a press conference at 11:00 a.m. ET, on
Monday, April 20, 2015, in the AAN Press Conference Room of the Walter E. Washington
Convention Center in Washington, DC.