TY - JOUR T1 - Outcome of seizures in the general population after 25 years: a prospective follow-up, observational cohort study JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 843 LP - 850 DO - 10.1136/jnnp-2015-312314 VL - 87 IS - 8 AU - Gail S Bell AU - Aidan Neligan AU - Christina Giavasi AU - Mark R Keezer AU - Jan Novy AU - Janet L Peacock AU - Anthony L Johnson AU - David M G Goodridge AU - Simon D Shorvon AU - Josemir W Sander Y1 - 2016/08/01 UR - http://jnnp.bmj.com/content/87/8/843.abstract N2 - Objectives We investigated long-term (to 25 years) seizure prognosis and survival in people with newly diagnosed epilepsy in the community. We explored whether prognosis is different in those with epilepsy (>2 unprovoked seizures) and those with a single seizure at presentation.Methods This is a prospective observational cohort study of people with newly diagnosed seizures. We investigated seizure outcome and survival in people presenting with a single seizure and in those presenting with >2 seizures (epilepsy).Results 695 people (median follow-up 23.6 years) had unprovoked epileptic seizures. For seizure analysis we excluded 38 people with missing data leaving 657 (309 male, and 249 aged <18 years). Seizures recurred in 67%. The 354 people with epilepsy were only slightly more likely to have further seizure recurrence than the 302 people with a single seizure at presentation (HR 1.32, 95% CI 1.09 to 1.59). In 327 people with complete follow-up, 268 (82%, 95% CI 77% to 86%) were in terminal remission; (80%, (95% CI 73% to 85%) in those with epilepsy at presentation). Premature mortality was increased in people with epilepsy (standardised mortality ratio 1.67; 95% CI 1.40 to 1.99) and those with a single seizure at presentation (standardised mortality ratio 2.65; 95% CI 2.23 to 3.15). It is also high in those with early remission.Conclusions People with epilepsy and with single seizures at presentation in the community generally have good prognosis for seizure control with prolonged follow-up. The risk of premature mortality is significantly increased in both groups. ER -