Evidence map›Paper›PMID 38539246›Full record

ArticleNeurological research and practice2024

First seizure in elderly patients: Need to treat? Evidence from a retrospective study.

Louise Linka, Benedikt Magnus, Nabard Faiz, Lena Habermehl, Panagiota-Eleni Tsalouchidou, Felix Zahnert, Leona Moeller, Kristina Krause, Susanne Knake, Katja Menzler

Open access · diamondAbstract read
In one paragraph

Article in Neurological research and practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.2field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Review
  3. Causal correlation between seizure activity and brain damage.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Louise LinkaDepartment of Neurology, Epilepsy Center Hessen, University Hospital Marburg, Philipps-University Marburg, Baldingerstr., 35043, Marburg, Germany.
Benedikt MagnusDepartment of Neurology, Epilepsy Center Hessen, University Hospital Marburg, Philipps-University Marburg, Baldingerstr., 35043, Marburg, Germany.
Nabard FaizDepartment of Neurology, Epilepsy Center Hessen, University Hospital Marburg, Philipps-University Marburg, Baldingerstr., 35043, Marburg, Germany.
Lena HabermehlDepartment of Neurology, Epilepsy Center Hessen, University Hospital Marburg, Philipps-University Marburg, Baldingerstr., 35043, Marburg, Germany.
Panagiota-Eleni TsalouchidouDepartment of Neurology, Epilepsy Center Hessen, University Hospital Marburg, Philipps-University Marburg, Baldingerstr., 35043, Marburg, Germany.
Felix ZahnertDepartment of Neurology, Epilepsy Center Hessen, University Hospital Marburg, Philipps-University Marburg, Baldingerstr., 35043, Marburg, Germany.
Leona MoellerDepartment of Neurology, Epilepsy Center Hessen, University Hospital Marburg, Philipps-University Marburg, Baldingerstr., 35043, Marburg, Germany.
Kristina KrauseDepartment of Neurology, Epilepsy Center Hessen, University Hospital Marburg, Philipps-University Marburg, Baldingerstr., 35043, Marburg, Germany.
Susanne KnakeDepartment of Neurology, Epilepsy Center Hessen, University Hospital Marburg, Philipps-University Marburg, Baldingerstr., 35043, Marburg, Germany.
Katja MenzlerDepartment of Neurology, Epilepsy Center Hessen, University Hospital Marburg, Philipps-University Marburg, Baldingerstr., 35043, Marburg, Germany. katja.menzler@med.uni-marburg.de.ORCID http://orcid.org/0000-0001-8289-480X
Philipps University of Marburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe risk of seizure recurrence after a first unprovoked epileptic seizure is reported to be approximately 40%. Little is known about the recurrence risk after a first seizure in elderly patients, who may be at higher risk due to an increased rate of structural lesions, encephalopathy, subcortical arteriosclerotic encephalopathy or brain atrophy.

methodsIn a retrospective approach, the recurrence rate in 304 patients aged 60 years and above who presented with a first seizure between 2004 and 2017 was analyzed. Hierarchical Cox regression was used to investigate the impact of EEG and neuroimaging results, age or the prescription of anti-seizure medication (ASM) on seizure recurrence.

resultsSeizure recurrence rates were 24.5% and 34.4% after one and two years, respectively. Anti-seizure medication was started in 87.8% of patients, in 28.8% despite the absence of clear epileptogenic lesions on neuroimaging or epileptiform potentials in the EEG. Medical treatment significantly reduced the risk of recurrence (hazard ratio = 0.47). Epileptiform potentials in the EEG, epileptogenic lesions in neuroimaging and age had no significant effect on seizure recurrence. Age and the presence of neurodegenerative and psychiatric comorbidities showed a significant association with ASM prescription.

conclusionsThe present data show a strong protective effect of ASM on seizure recurrence in patients above the age of 60, even in the absence of pathologic neuroimaging or EEG results needed for the diagnosis of epilepsy. Treatment with ASM therefore seems beneficial for reducing the recurrence risk in elderly patients. The lack of a significant association between seizure recurrence and epileptogenic lesions might be related to other confounding factors like encephalopathy, subcortical arteriosclerotic encephalopathy, neurodegenerative diseases or brain atrophy.

Indexed as

Anti-seizure medicationElderlyFirst epileptic seizureILAERecurrence

Identifiers

PMID38539246
PMCPMC10976763
OpenAlexW4394741069

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.