Background: In recent years, several studies have been conducted to determine the risk relapse after antiepileptic drug (AED) withdrawal: there is no general agreement on criterthat can predict safe discontinuation or seizure recurrence. Aims: To evaluate prospectively the relapse rate of epilepsy associated to AED withdrawin epileptic children and to determine the risk factors of seizure recurrence. Methods: One hundred-sixty-eight children with epilepsy who were seizure-free for at lea2 years were enrolled and all children were proposed to stop AED treatment and wefollowed. In all children electroencephalograms (EEGs) were performed before the withdrawof AEDs and after discontinuation of the treatment. Results: A total of 48 (28.6%) children relapsed; half of these patients relapsed whireducing the AED dose and the other half after the AED was withdrawn; after 2 yeawithout AEDs, the risk of relapse was very low. Data evaluated by multivariable analysshowed that the children receiving polytherapy before AED withdrawal, having a history febrile seizures and suffering from multiple seizure types relapsed more frequently. Thpresence of abnormal post-withdrawal EEG recordings was associated with a higher risk seizure recurrence. Conclusions: Epileptic children, after a seizure-free period of 2 years, have a low risk seizure recurrence. The potential risk factors of relapse, are multiple seizure types previoupolytherapy, history of febrile seizures and abnormalities in post-withdrawal EEG. a 2012 European Paediatric Neurology Society. Published by Elsevier Ltd. All righ
Antiepileptic drug withdrawal in childhood epilepsy: What are the risk factors associated with seizure relapse?
VERROTTI DI PIANELLA, ALBERTO;
2012
Abstract
Background: In recent years, several studies have been conducted to determine the risk relapse after antiepileptic drug (AED) withdrawal: there is no general agreement on criterthat can predict safe discontinuation or seizure recurrence. Aims: To evaluate prospectively the relapse rate of epilepsy associated to AED withdrawin epileptic children and to determine the risk factors of seizure recurrence. Methods: One hundred-sixty-eight children with epilepsy who were seizure-free for at lea2 years were enrolled and all children were proposed to stop AED treatment and wefollowed. In all children electroencephalograms (EEGs) were performed before the withdrawof AEDs and after discontinuation of the treatment. Results: A total of 48 (28.6%) children relapsed; half of these patients relapsed whireducing the AED dose and the other half after the AED was withdrawn; after 2 yeawithout AEDs, the risk of relapse was very low. Data evaluated by multivariable analysshowed that the children receiving polytherapy before AED withdrawal, having a history febrile seizures and suffering from multiple seizure types relapsed more frequently. Thpresence of abnormal post-withdrawal EEG recordings was associated with a higher risk seizure recurrence. Conclusions: Epileptic children, after a seizure-free period of 2 years, have a low risk seizure recurrence. The potential risk factors of relapse, are multiple seizure types previoupolytherapy, history of febrile seizures and abnormalities in post-withdrawal EEG. a 2012 European Paediatric Neurology Society. Published by Elsevier Ltd. All righI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
