Outcome of Second Anti-seizure Medication Withdrawal in Pediatric Onset Epilepsy Patients
Abstract number :
1.225
Submission category :
4. Clinical Epilepsy / 4C. Clinical Treatments
Year :
2022
Submission ID :
2204104
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:23 AM
Authors :
Hye Jin Kim, MD – Seoul National University Children's Hospital; Jong-Hee Chae, MD PHD – Seoul National University Children's Hospital; Jieun Choi, MD PHD – Seoul Boramae Hospital; Hunmin Kim, MD PHD – Seoul National University Bundang Hospital; Ki-joong Kim, MD PHD – Seoul National University Children's Hospital; Soo yeon Kim, MD – Seoul National University Children's Hospital; Woojoong Kim, MD – Seoul National University Children's Hospital; Byung Chan Lim, MD PHD – Seoul National University Children's Hospital; Hey Joon Son, MD – Seoul National University Children's Hospital; Jae so Cho, MD – Seoul National University Children's Hospital
Rationale: The purpose of this study is to determine second anti-seizure medication withdrawal outcome in pediatric onset epilepsy patients and determine factors that significantly affect second anti-seizure medication withdrawal outcome in pediatric onset epilepsy patients._x000D_
Methods: Pediatric onset epilepsy patients who underwent second anti-seizure medication withdrawal in Seoul National University Children’s Hospital and Seoul National University Bundang Hospital during 2003 ~ 2022 were included in the retrospective analysis. Patients who underwent brain surgery and less than 1 year anti-seizure medication treatment period during their initial treatment were excluded.
Results: A total of 104 patients were recruited for analysis. Fifty patients were male (46.7%) and 54 patients were female (51.9%). Mean age of diagnosis was 7.7 years (4.2-11.1 years). Twelve patients had abnormal finding in their initial MRI (11.5%) and 10 patients had developmental delay or intellectual disability (9.3%). Four patients had family history of epilepsy (3.8%) and 7 patients had history of febrile seizures (6.7%). Self-limiting epilepsy syndromes were diagnosed in 16 patients (15.4%) and 15 patients had structural, infectious, immune or genetic etiologies (14.4%). One year seizure free period after second anti-seizure medication withdrawal was obtained in 43 patients (41.3%). Etiologies, self-limiting epilepsy syndromes, epilepsy duration period, seizure free interval before second anti-seizure medication withdrawal were factors that significantly affected successful second withdrawal of anti-seizure medication in pediatric onset epilepsy patients. In the multiple logistic regression analysis, self-limiting epilepsy syndrome and seizure free duration period before withdrawal were the two most significant factors affecting the outcome of second anti-seizure medication withdrawal.
Conclusions: Less than half of the patients achieved 1 year seizure free period after second anti-seizure medication withdrawal (41.3%). Identification of of self-limiting epilepsy syndromes and having long term seizure free period before second withdrawal maybe important when withdrawing anti-seizure medication for the second time. _x000D_
Funding: None
Clinical Epilepsy