Long-term seizure recurrence after eclampsia: A systematic review and meta-analysis

Background Seizure recurrence after a fit has implications for both individuals and healthcare providers guiding neurologic prognosis, treatment, and driving and work restrictions. A systematic review of long-term seizure recurrence after eclampsia will help to quantify recurrence risk in this setting. Objective To evaluate the long-term recurrence of seizures after eclampsia. Search strategy After PROSPERO registration, Medline (Ovid), Embase, and Cochrane Library were searched by using the terms (eclampsia OR eclamp* OR eclamptic seizure* OR eclamptic fit*) AND (recur* OR recurrent fit* OR recurrent seizure*) for studies published up until December 2019. Selection criteria Studies describing long-term seizure recurrence after a diagnosis of eclampsia were included. Data collection and analysis Data were extracted from studies independently by two authors. Pooled prevalence was calculated and weighted based on sample size with a 95% confidence interval (CI). Main results Initially, 1754 unique studies were identified and 4 were included in the final analysis. The studies involved 1896 women, of whom 7 (0.37%) were affected by a further seizure. The weighted pooled prevalence of seizure recurrence was 0.18% (95% CI, 0.03-1.02). Conclusion The absolute rate of long-term seizure recurrence after eclampsia is extremely low and within safe limits for driving.