{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:57:31Z","timestamp":1791471451605,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Acute symptomatic epileptic seizures (ASySs) occur in temporal proximity to acute brain insults. Given their low risk of subsequent unprovoked seizures, current guidelines recommend either no treatment with anti\u2010seizure medication (ASM) or early discontinuation, yet ASM treatment is often continued beyond hospital discharge. We aimed at investigating the cumulative 3\u2010year risk and predictors of unprovoked seizures after ASySs and assessing the effect of ASM treatment duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The prospective, multicenter register on the prognosis of acute symptomatic seizures (PROSE register) recruited adults with clinically apparent, acute symptomatic, first\u2010ever epileptic seizure, excluding status epilepticus. Primary endpoint was occurrence of a first unprovoked seizure. The impact of ASM treatment duration was assessed through a Cox regression correcting for treatment selection bias. The chance of occurrence of a seizure in the next year (COSY) was calculated to evaluate driving eligibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 3\u2010year cumulative incidence of unprovoked seizures was 14% [95% confidence interval (CI): 7%\u201321%] among 122 participants with structural etiologies. Male sex (hazard ratio [HR] 9.3; 95% CI 19\u201345.1), early epileptiform electroencephalography (EEG) activity (HR 7.4; 95% CI 1.8\u201331.1), and latency \u226548\u2009h between onset of underlying condition and ASyS (HR 4.8; 95% CI 1.3\u201318.1) were independently associated with unprovoked seizures. ASM treatment duration had no apparent effect (HR 1; 95% CI 1\u20131;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.84). The initial COSY was 10% and fell below 2% within 2\u2009years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Even in structural etiologies, ASySs bear a relatively low risk of later unprovoked seizures. There is still no evidence favoring prolonged ASM treatments. These findings may help preventing ASM overtreatment and guide counseling on driving eligibility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70521","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:25:38Z","timestamp":1791469538000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognosis of acute symptomatic seizures and impact of prolonged treatment with anti\u2010seizure medication"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7674-4426","authenticated-orcid":false,"given":"Hannah","family":"Traben","sequence":"first","affiliation":[{"name":"Epilepsy\u2010Center Berlin\u2010Brandenburg, Department of Neurology Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5365-8231","authenticated-orcid":false,"given":"Julia","family":"Herzig\u2010Nichtwei\u00df","sequence":"additional","affiliation":[{"name":"Epilepsy\u2010Center Berlin\u2010Brandenburg, Department of Neurology Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9745-7258","authenticated-orcid":false,"given":"Lisa","family":"Langenbruch","sequence":"additional","affiliation":[{"name":"Department of Neurology Klinikum Osnabr\u00fcck  Osnabr\u00fcck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4429-0367","authenticated-orcid":false,"given":"Felix","family":"Kohle","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medicine University of Cologne and University Hospital of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4391-2280","authenticated-orcid":false,"given":"Johann O.","family":"Pelz","sequence":"additional","affiliation":[{"name":"Department and Policlinic of Neurology Leipzig University Medicine  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2101-6066","authenticated-orcid":false,"given":"Piergiorgio","family":"Lochner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty Saarland University Medical Center  Homburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9904-6436","authenticated-orcid":false,"given":"Matthias","family":"Wittstock","sequence":"additional","affiliation":[{"name":"Department of Neurology Rostock University Medical Center  Rostock 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