This can explained by following the reference to the study: > Two large-scale randomized trials provided definitive estimates of the risk of recurrence after a

This can explained by following the reference to the study: > Two large-scale randomized trials provided definitive estimates of the risk of recurrence after an untreated first unprovoked, seizure. These are the multicenter study from Italy, FIR.S.T (First Seizure Trial Group, 1993) and the European-wide Multicenter Epilepsy and Single Seizure study or MESS, which included both first seizures and newly recognized epilepsy (Marson et al., 2005). Based on 193 patients randomized to deferred treatment only in the event of a second seizure (i.e., initially untreated), the FIR.S.T study reported recurrence risks of 18%, 28%, 41%, and 51% at 3, 6, 12, and 24 months after the initial seizure. In the MESS study, 408 patients with a first unprovoked seizure were randomized to the deferred treatment group. Their risk of recurrence at 6 months, 2, 5, and 8 years after randomization was 26%, 39%, 51%, and 52%. On average, the observational studies, taken as a whole, provide an estimate of the 2-year recurrence risk in the range of 40%, depending on aspects of the study design (Berg & Shinnar, 1991). > Both of the randomized trials, especially the second, demonstrate a pattern seen in virtually all of the long-term observational studies of first seizures. Specifically, the risk of a recurrence is highest during the period immediately after the initial seizure. The rate, at which first recurrences occur, drops off with increasing time since the first seizure. Across a number of studies with prolonged follow-up periods, 80–90% of individuals who recur do so within 2 years of the initial seizure (Annegers et al., 1986; Hopkins et al., 1988; Boulloche et al., 1989; Hauser et al., 1990; Shinnar et al., 1996).