Withdrawal of Antiepileptic Drugs in Children with Idiopathic Epilepsy
Abstract number :
2.316
Submission category :
7. Antiepileptic Drugs / 7E. Other
Year :
2017
Submission ID :
346020
Source :
www.aesnet.org
Presentation date :
12/3/2017 3:07:12 PM
Published date :
Nov 20, 2017, 11:02 AM
Authors :
Soo Yeon Kim, Seoul National University Children's Hospital; Hyuna Kim, Seoul National University Children's Hospital; Woo Joong Kim, Seoul National University Children's Hospital; Youngkue Shim, Seoul National University Children's Hospital; Sun Ah Choi,
Rationale: Withdrawal of antiepileptic drugs (AEDs) is one of the most important issues in epilepsy. This study was aimed to describe the consequences of AEDs withdrawal and identify risk factors for seizure recurrence in children with idiopathic epilepsy. Methods: Patients with idiopathic epilepsy whose seizure onset age was below 18 years old were included. Retrospective review of medical record and data analysis was done for 316 patients. Results: Among 316 patients, 188 were male (59.5%). The mean age at seizure onset and beginning of withdrawal was 6.9 years (range, 0-16 years) and 11.7 years (range, 0.1-27.6 years) respectively. The mean total treatment duration was 4.1 years (range, 0-17.5 years) and mean follow-up duration after the withdrawal was 6.3 years (range, 0.4-22.5 years). Seizure recurred in 107 patients (33.9%), during the withdrawal (50 patients, 46.7%) or after the tapering (57 patients, 53.3%). The mean duration from AED off to seizure recur was 16.2 months (range, 0-90 months). Only 5 of 31 (16.1%) patients with childhood absence epilepsy (CAE) and 2 of 46 patients (0.04%) with benign epilepsy with centrotemporal spikes (BECTS) had recurred seizure, whereas 49 of 112 (43.8%) with unclassified focal and 14 of 23 (60.9%) with unclassified generalized epilepsy did. Risk factors for seizure recurrence were evaluated by logistic regression analysis in patients with BECTS, CAE, and other idiopathic focal and generalized epilepsy. Younger age of seizure onset (p=0.022) and two or more number of AEDs at the time of withdrawal (p=0.002) were independent factors for increasing seizure recur, whereas normalization of electroencephalogram or seizure-free duration before withdrawal showed no significant relationship with seizure recurrence. Conclusions: Patients with benign epilepsy syndromes showed fair outcome after withdrawal of AEDs. In overall inspection, younger age of seizure onset and large number of AEDs at withdrawal might increase risk for seizure recurrence. Funding: There are no funding sources for this abstract.
Antiepileptic Drugs