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 VOL. 23, NO. 15FEBRUARY 20, 1998 

Researchers Redefine the Definition of Epilepsy


Two or three unprovoked seizures may greatly increase the risk for more seizures and should be necessary criteria for defining epilepsy, according to a recent study by researchers at Columbia’s College of Physicians and Surgeons. The study, published in the Feb. 12 New England Journal of Medicine, establishes the first mathematically sound definition of epilepsy. The data could lead to a better understanding of seizure occurrence and more appropriate treatment intervention.

  Epilepsy, a condition that affects approximately 2.5 million Americans, is a condition characterized by recurrent unprovoked seizures.

  “There has been a debate in the medical community about how many seizures that means and when a person should be treated for epilepsy,” says W. Allen Hauser, lead author and professor of neurology and public health in the Gertrude H. Sergievsky Center.

  “This study shows that two seizures are necessary and sufficient criteria for defining epilepsy. It provides a prediction of risk of seizure recurrence for people newly diagnosed with epilepsy.”

  The study, funded in part by the National Institute of Neurological Disorders and Stroke, followed 204 patients for a mean of eight years, beginning at the diagnosis of their irst unprovoked seizure. Only one-third of the original group had more seizures within five years.

  However, once patients had a second seizure, their risk of a third jumped to 73 percent. Patients who had three seizures had a 76 percent risk of a fourth.

  “Once a patient has a second seizure, the risk of having a third or fourth is quite high,” says Hauser. “So the implication is that patients should be treated after their second seizure.”

  In the United States, approximately 150,000 people are diagnosed with epilepsy each year. Other investigators are Steven Rich; Ju R.-J. Lee; John Annegers, and V. Elving Anderson.