The role of brain computer tomography in evaluating children with new onset seizures in the emergency department. Their etiology can be broken down into cryptogenic (no known etiology), Shinnar S, Berg AT, Moshe SL, et al. Pediatric First Unprovoked Seizure. The first unprovoked, untreated seizure in childhood: a hospital based study of the accuracy of the diagnosis, rate of recurrence, and long term outcome after recurrence. The majority of children who experience a first unprovoked seizure will have few or no recurrence; only approximately 10% will go on to have many (≥10) seizures regardless of therapy. Treatment with AED after a first seizure as opposed to after a second seizure has not been shown to improve prognosis for long-term seizure remission. Matyal J, Krauss JM, Novak G, et al. Some authorities believe the overall recurrence risk for another seizure after a first unprovoked episode is 45% (22% at 6 months, 29% at 12 months, 37% at 24 months, 43% at 60 months and 46% at 120 months) . On the contrary, unprovoked seizure is not associated with an obvious precipitating cause and may be related to epilepsy. First-time unprovoked seizure — The decision whether to treat a child with an antiseizure drug after an initial unprovoked seizure should be individualized, weighing the risks of recurrent seizure against the potential risks and benefits of antiseizure drug therapy and incorporating patient values and preferences. Seizures occur when a large number of nerve cells in the brain send out an electrical signal at the same time, overwhelming the brain and causing the body to seize. 13. Pediatrics 1996;98(2 Pt 1):216-225. 12. The risk of seizure recurrence after a first unprovoked afebrile seizure in childhood: An extended follow-up. Evidence-based guideline: Management of an unprovoked first seizure in adults Report of the Guideline Development Subcommittee of the American … Every year, an estimated 25,000 to 40,000 U.S. children experience their first unprovoked seizure, which includes those not caused by fever, head trauma, intracranial infection, various metabolic disturbances or other causes.