{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:51:09Z","timestamp":1785462669088,"version":"3.56.0"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T00:00:00Z","timestamp":1708128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>There are limited data on first seizure (FS) among adults in low and middle\u2010income countries. We describe findings from a prospective cohort study involving 180 adults presenting with seizures in emergency departments in five Latin American countries. Overall, 102 participants (56.7%) had acute symptomatic seizures (ASyS) while 78 (43.3%) had unprovoked seizures (UPS). Among patients with ASyS, 55 (53.9%) had structural causes, with stroke (<jats:italic>n<\/jats:italic>\u2009=\u200924, 23.5%), tumor (<jats:italic>n<\/jats:italic>\u2009=\u200910, 9.8%), and trauma (<jats:italic>n<\/jats:italic>\u2009=\u20093, 3%) being the most frequent. Nineteen patients (18.6%) had infectious causes, including four (4%) with meningoencephalitis, three (3%) neurocysticercosis, and two (2%) bacterial meningoencephalitis. Twenty patients (19.6%) had metabolic\/toxic evidence, including four (4%) with uremic encephalopathy, two (2%) hyponatremia, and three (3%) acute alcohol intoxication. Immune dysfunction was present in seven (7%) patients and neurodegenerative in two (2%). Among participants with UPS, 45 (57.7%) had unknown etiology, 24 (30.7%) had evidence of structural disorders (remote symptomatic), four (5%) were related to infectious etiology (&gt;7\u2009days before the seizure), and five (6.4%) had genetic causes. During the 3\u2010 and 6\u2010month follow\u2010up, 29.8% and 14% of patients with UPS, respectively, experienced seizure recurrence, while 23.9% and 24.5% of patients with ASyS had seizure recurrence. Longer follow\u2010up is necessary to assess seizure recurrence for patients with ASyS after the acute cause is resolved and to determine the 10\u2010year risk of recurrence, which is part of the definition of epilepsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>We monitored 180 adults who presented with their first seizure in emergency departments across five Latin American countries. Among these patients, 57% had acute symptomatic seizures, with structural causes such as stroke (23%), infection (17%), or tumor (10%) being more prevalent. Among the 43% with unprovoked seizures, 58% showed no identifiable acute cause, while 6.4% were due to genetics. Within 3\u2009months after their initial seizure, 26.6% of individuals experienced a second seizure, with 11.9% continuing to have seizures in Months 3\u20136. Between Months 3 and 6, an additional 20% of patients encountered a second seizure. Research is needed to better understand the cause and prognosis of these patients to improve outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12900","type":"journal-article","created":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T05:45:30Z","timestamp":1708148730000},"page":"776-784","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5821-6379","authenticated-orcid":false,"given":"Arturo","family":"Carpio","sequence":"first","affiliation":[{"name":"School of Medicine University of Cuenca  Cuenca Ecuador"},{"name":"Hospital Santa In\u00e9s  Cuenca Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Salgado","sequence":"additional","affiliation":[{"name":"Facultad de Medicina Universidad de Azuay  Cuenca Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"DiCapua","sequence":"additional","affiliation":[{"name":"Hospital Eugenio Espejo Ministerio de Salud P\u00fablica  Quito Ecuador"},{"name":"Universidad San Francisco de Quito  Quito Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Fleury","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Gen\u00f3mica y Toxicolog\u00eda Ambiental Instituto de Investigaci\u00f3n Biom\u00e9dicas, Universidad Nacional Aut\u00f3noma de M\u00e9xico  Ciudad de Mexico Mexico"},{"name":"Instituto Nacional de Neurolog\u00eda y Neurocirugia de  Ciudad de Mexico Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Suastegui","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Neurolog\u00eda y Neurocirugia de  Ciudad de Mexico Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Giagante","sequence":"additional","affiliation":[{"name":"Hospital Interzonal General de Agudos Prof. Dr. Rodolfo Rossi de La Plata  La Plata Argentina"},{"name":"Hospital de Alta Complejidad El Cruce \u201cN\u00e9stor Kirchner\u201d, ENyS, CONICET  Florencio Varela Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ledda","family":"Aguilera","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico de la Universidad de Chile  Santiago de Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alonso","family":"Quijada","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico de la Universidad de Chile  Santiago de Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilia","family":"Nu\u00f1ez","sequence":"additional","affiliation":[{"name":"Hospital 20 de Noviembre  Ciudad de Mexico Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Villanueva","sequence":"additional","affiliation":[{"name":"Hospital de Alta Complejidad El Cruce \u201cN\u00e9stor Kirchner\u201d, ENyS, CONICET  Florencio Varela Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel","family":"Plascencia\u2010Alvarez","sequence":"additional","affiliation":[{"name":"Hospital 20 de Noviembre  Ciudad de Mexico Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6436-9307","authenticated-orcid":false,"given":"Pedro T","family":"Hamamoto\u00a0Filho","sequence":"additional","affiliation":[{"name":"Botucatu Medical School UNESP \u2013 S\u00e3o Paulo State University  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis M.","family":"Piedra","sequence":"additional","affiliation":[{"name":"Hospital \u201cJos\u00e9 Carrasco\u201d Instituto Ecuatoriano de Seguridad Social de Cuenca  Cuenca Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Silva\u2010Rosas","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico de la Universidad de Chile  Santiago de Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Kelvin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology &amp; Biostatistics, CUNY Graduate School of Public Health and Health Policy City University of New York  New York New York USA"},{"name":"CUNY Institute for Implementation Science in Population Health City University of New York  New York New York USA"},{"name":"Department of Occupational Health Epidemiology &amp; Prevention Donald and Barbara Zucker School of Medicine at Hofstra University\/Northwell Health  Hempstead New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.4065\/71.6.576"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12550"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2008.01443.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2009.02285.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009980"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1684\/epd.2016.0853"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-007325"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10871-5"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2008.01444.x"},{"issue":"1","key":"e_1_2_9_11_1","article-title":"Prognosis of adults and children following a first unprovoked seizure","volume":"1","author":"Neligan A","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1684\/epd.2021.1376"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2008.01945.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1684\/epd.2021.1255"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2021.02.019"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001866"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(70)90054-8"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425787"},{"key":"e_1_2_9_19_1","unstructured":"GDP per capita (current US$) \u2013 Latin America & Caribbean.2023;https:\/\/data.worldbank.org\/indicator\/NY.GDP.PCAP.CD?locations=ZJ&most_recent_value_desc=true. 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