Do seizures beget seizures?

Abstract

There have been suggestions that seizures in some way modify brain function and that each seizure increases the risk for further seizures. Reports thus far on this phenomenon have been flawed because of inappropriate study design. We have evaluated the risk for seizure recurrence following a first unprovoked seizure in a cohort identified at their first unprovoked seizure. Individuals with low risk for a seizure recurrence demonstrate a significant increase in risk for seizure recurrence with increasing numbers of seizures. This is the first time that a progressive increase in risk for seizures with increasing number of seizures has been demonstrated in humans. Since the majority of these cases will ultimately go into remission and discontinue antiseizure medication, there must be competing forces that increase seizure risk and promote seizure suppression. We need appropriate animal models to better understand both processes and their interactions.