Follow‐Up of 146 Children with Epilepsy after Withdrawal of Antiepileptic Therapy

Arts, W. F. M.; Visser, Leo H.; Loonen, M. C. B.; Tjiam, A. T.; Stroink, Hans; Stuurman, P M; Poortvliet, D.C.J.

doi:10.1111/j.1528-1157.1988.tb03713.x

Cited by 91 publications

(61 citation statements)

References 11 publications

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“…Seizure relapse rates after AEDs withdrawal have been reported as 22.4-40.0% and 85-90% of all those relapses that occur in the first two years of withdrawal [10][11][12][13][14][15]. Accordingly, children should be followed closely during the first two years after AEDs withdrawal.…”

Section: Discussionmentioning

confidence: 99%

“…The most important point to withdraw antiepileptic drugs (AEDs) is the presence of a seizure free period of at least two years in an epileptic patient. The relapse rates in childhood-onset epilepsy have been reported as 22.4-40.0% after AEDs withdrawal [10][11][12][13][14]. Thus, determination of the risk factors for relapse after AEDs withdrawal is crucial to minimize the seizure relapse rates.…”

Section: Introductionmentioning

confidence: 99%

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Determination of risk factors associated with seizure relapse after antiepileptic drug withdrawal

et al. 2010

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AbstractThere is no consensus regarding the time of antiepileptic drug withdrawal and the relevant risk factors for seizure relapse. In this study, we aimed to determine the seizure relapse rates and the associated risk factors for seizure relapse in childhood epilepsy. Two-hundred sixty-six epileptic patients who discontinued the antiepileptic drug therapy after a seizure-free period of at least two years, were enrolled into the study. The data of the patients regarding sex, febrile convulsion history, family history, age at onset, type of epilepsy, total number of seizures and antiepileptic drugs, seizures during treatment, mental status, first and last electroencephalography, brain imaging findings, etiological factors and seizure relapse in the first two years after antiepileptic drug withdrawal were obtained from the patients’ files. Univariate logistic regression analysis was performed for each variable. The variables which were found to be statistically significant in univariate analysis, were included in multivariate logistic regression analysis. The overall seizure relapse rate after antiepileptic drug withdrawal was 19.2%. There were no significant differences for seizure relapse rate after antiepileptic drug withdrawal between patient groups with respect to sex, family history, type of epilepsy, febrile convulsion history, seizures before treatment, first electroencephalography findings, brain imaging findings and etiology. However, there were statistically significant differences for seizure relapse rate among patient groups concerning age at onset of epilepsy, new seizure during treatment, the total number of antiepileptic drugs, mental status, and last electroencephalography findings. We imply that the clinical status of the patients should be considered before the cessation of drug therapy rather than the etiological factors or laboratory findings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Determination of risk factors associated with seizure relapse after antiepileptic drug withdrawal

et al. 2010

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“…Many studies have focused on these issues, and different risk factors for poor prognosis have been recognized (1)(2)(3)(4)(5)(6). Several studies have shown that children with neurological abnormalities or severe forms of epilepsy, such as infantile spasms (IS) or Lennox-Gastaut syndrome (LGS) have poor prognoses in terms of seizure control (3)(4)(5)(6)(7). Other risk factors related to outcome, such as seizure type, age at seizure onset, and EEG abnormalities, have been identified, but the results of earlier studies are not unanimous (1,(6)(7)(8)(9).…”

mentioning

confidence: 99%

“…Several studies have shown that children with neurological abnormalities or severe forms of epilepsy, such as infantile spasms (IS) or Lennox-Gastaut syndrome (LGS) have poor prognoses in terms of seizure control (3)(4)(5)(6)(7). Other risk factors related to outcome, such as seizure type, age at seizure onset, and EEG abnormalities, have been identified, but the results of earlier studies are not unanimous (1,(6)(7)(8)(9). In a Accepted December 19, 1996. Address correspondence and reprint requests to Dr. G. Braathen at Department of Pediatrics, Huddinge University Hospital, S-141 86 Huddinge, Sweden.…”

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confidence: 99%

Early Discontinuation of Treatment in Children with Uncomplicated Epilepsy: A Prospective Study with a Model for Prediction of Outcome

Braathen

Melander

1997

Epilepsia

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Summary: Purpose: The main purpose of the present study was to identify predictor variables with significant influence on seizure outcome after discontinuation of treatment in children with uncomplicated epilepsy and to analyze whether these variables, included in a prognostic model could identify children in whom 1‐year treatment would be sufficient. Methods: Before initiation of treatment in children aged 2–16 years with uncomplicated epilepsy, the duration of treatment was randomized to 1 year (group I) or 3 years (group II). At the end of the allotted period, treatment was discontinued in 161 children who had been seizure free during the previous 6 months. The mean follow‐up period after treatment was 5.8 years. Twenty‐three predictor variables were analyzed by survival methods regarding their influences on the outcome. Results: At the latest follow‐up check, 60 children (37%) had relapsed. The following predictor variables were selected by multiple regression analysis and constituted a model with a simple scoring system: age at seizure onset; seizure type; generalized, irregular spike‐wave activity on EEG after 1 year of treatment; and persistent 3‐Hz spike‐wave activity after 6 months of treatment in children with absence epilepsy. In group I, the remission rate was 73% in children with high prognostic scores, 10% in children with low scores, and 40% in those with intermediate scores (log‐rank test, p = 0.0001). Conclusions: After 1 year of treatment, our prognostic model identified children in whom treatment could be withdrawn at that time. Our model should be easily applicable in clinical practices and may be of clinical importance in determining the duration of treatment in children with uncomplicated epilepsy.

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“…Epilepsy is more commonly found in the hemiplegia and quadriplegia spastic type. [11][12] This study aimed to find the prevalence and risk factors of epilepsy in children with CP in Cipto mangunkusumo Hospital, Jakarta.…”

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Prevalence and risk factors for epilepsy in children with spastic cerebral palsy

Rahmat

Mangunatmadja

Tridjaja

et al. 2016

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Background epilepsy in cerebral palsy (CP) is usually difficult to treat and can lead to poor prognosis due to increased risk for motor and cognitive disorders. The prevalence and risk factors of epilepsy in children with CP vary among studies. Objective To determine the prevalence and risk factors for epilepsy in spastic CP. Methods We performed a retrospective study using medical records of patients with spastic CP at the Departement of Child Health, Cipto Mangunkusumo Hospital from January 2003 until December 2008. Prevalence ratio was calculated by comparing the prevalence of epilepsy in subjects with and without risk factors. We excluded patients with metabolic disorder, genetic syndrome, and onset of CP after 3 years of age. Results Two hundred thirty six out of 238 spastic CP patients were analyzed. The mean age at diagnosis of spastic CP was 28.8 months. male to female ratio was 1.4:1. The prevalence of epilepsy in spastic CP was 39%. The risk factors for epilepsy in spastic CP were central nervous system infection, the ocurrence of seizure in the first year of life, and abnormality of eeG. Conclusions The prevalence of epilepsy in spastic CP is 39%. The risk factors for epilepsy in spastic CP are post central nervous system infection, and ocurrence of seizure in the first year of life.

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Follow‐Up of 146 Children with Epilepsy after Withdrawal of Antiepileptic Therapy

Cited by 91 publications

References 11 publications

Determination of risk factors associated with seizure relapse after antiepileptic drug withdrawal

Determination of risk factors associated with seizure relapse after antiepileptic drug withdrawal

Early Discontinuation of Treatment in Children with Uncomplicated Epilepsy: A Prospective Study with a Model for Prediction of Outcome

Prevalence and risk factors for epilepsy in children with spastic cerebral palsy

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