Recurrence risk after withdrawal of antiepileptic drugs in children with epilepsy: A prospective study

Ramos-Lizana, Julio; Aguirre-Rodríguez, J.; Aguilera-López, P.; Cassinello-García, E.

doi:10.1016/j.ejpn.2009.05.006

Cited by 52 publications

(66 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The 6-month cohort experienced a relapse rate of 55%, compared with 49% for the longer-treatment cohort. The magnitude of these relapse rates is consistent with the findings of the MRC randomized trial [14], as well as with more recent prospective withdrawal trials focusing on the pediatric population [24,25,26,27,28,29,30]. As with adults, the data are relatively conclusive in showing that AED withdrawal is associated with a substantially increased risk of seizure recurrence, especially earlier in the time course after the discontinuation.…”

Section: Introductionsupporting

confidence: 86%

“…About 10% of childhood epilepsy syndromes, including syndromes such as juvenile myoclonic epilepsy and reading epilepsy, will never remit, and thus an AED withdrawal trial would not be advisable, even after a period of seizure freedom [22]. Syndromes with an intermediate prognosis include the localization-related epilepsies, which have been shown to have a higher risk of recurrence in multiple studies [23,24,26,28,30]. However, a diagnosis of localization-related epilepsy should not uniformly prevent an AED withdrawal trial in seizure-free pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

“…Other factors that have been associated with a higher relapse risk include adolescent age of onset [12,25], a symptomatic etiology [12,28,30], an abnormal neurologic examination [19,25], and an epileptiform EEG pattern before or after withdrawal [12,23,29,32]. An early response to the initial AED therapy has been associated with a lower risk of seizure recurrence [12,19].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Stopping Antiepileptic Drugs: When and Why?

Hixson

2010

Curr Treat Options Neurol

View full text Add to dashboard Cite

Opinion statementAfter a patient has initiated an antiepileptic drug (AED) and achieved a sustained period of seizure freedom, the bias towards continuing therapy indefinitely can be substantial. Studies show that the rate of seizure recurrence after AED withdrawal is about two to three times the rate in patients who continue AEDs, but there are many benefits to AED withdrawal that should be evaluated on an individualized basis. AED discontinuation may be considered in patients whose seizures have been completely controlled for a prolonged period, typically 1 to 2 years for children and 2 to 5 years for adults. For children, symptomatic epilepsy, adolescent onset, and a longer time to achieve seizure control are associated with a worse prognosis. In adults, factors such as a longer duration of epilepsy, an abnormal neurologic examination, an abnormal EEG, and certain epilepsy syndromes are known to increase the risk of recurrence. Even in patients with a favorable prognosis, however, the risk of relapse can be as high as 20% to 25%. Before withdrawing AEDs, patients should be counseled about their individual risk for relapse and the potential implications of a recurrent seizure, particularly for safety and driving.

show abstract

Section: Introductionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Stopping Antiepileptic Drugs: When and Why?

Hixson

2010

Curr Treat Options Neurol

View full text Add to dashboard Cite

show abstract

“…Some previous studies have reported that seizure type is a significant risk factor,[1718] whereas others did not. [271014] Verrotti et al .…”

Section: Discussionmentioning

confidence: 99%

Risk of recurrence after discontinuation of antiepileptic drug therapy in children with epilepsy

et al. 2014

View full text Add to dashboard Cite

Objectives:The numerous antiepileptic drug (AED) withdrawal studies published in the last 40 years have relied mainly on heterogeneous study groups. There is still no general agreement on the criteria to predict safe discontinuation. The goal of this study was to assess the outcome of AED withdrawal in epileptic children.Materials and Methods:Three hundred and eight children with epilepsy were enrolled, and these patients followed at least 1 year after drug withdrawal. Time to seizure relapse and predictive factors were analyzed by survival methods.Results:Among the 308 patients, 179 (58.1%) were boys and 129 (41.9%) were girls and the mean age at the seizure onset was 60.41 ± 36.54 months (2-144 months). The recurrence occurred in 73 (23.7%) patients. Mental retardation, history of febrile seizure, etiological of epilepsy, abnormal first electroencephalogram (EEG), abnormal neuroimaging findings, and total number of AED before remission were significantly associated with relapse risk according to univariate analysis. In the multivariate analysis, abnormal first EEG and number of AED before remission (polytherapy) were the risk factors influencing seizure recurrence.Conclusions:In our study, recurrence rate was 23.7% in children and most occurred during the 1st year. The potential risk factors of recurrence are history of febrile seizure, mental retardation, etiological of epilepsy, abnormal first EEG, abnormal neuroimaging findings, and total number of AED before remission. However, we found abnormal first EEG and polytherapy as risk factors of recurrence in multivariate analysis.

show abstract

“…Progression is age-dependent, beginning at about 3 to 13 years and disappearing at age 14 to 18 years. BECTS is regarded as an epilepsy syndrome with a favorable long-term prognosis, characterized by low seizure frequency, lack of neurological or intellectual deficits, spontaneous remission by puberty, and low seizure recurrence rate after remission [1,2]. Due to its benign course, BECTS is often not treated.…”

Section: Introductionmentioning

confidence: 99%

Language Dysfunction Is Associated with Age of Onset of Benign Epilepsy with Centrotemporal Spikes in Children

Ma¹,

Chen²,

Wang³

et al. 2015

Eur Neurol

View full text Add to dashboard Cite

Aims: To assess the language function of children with benign epilepsy with centrotemporal spikes (BECTS), and investigate associated risk factors. Methods: The language function of 63 children with BECTS and 30 healthy controls was assessed using the language subtest of the Chinese version of the Wechsler Intelligence Scale for Children (C-WISC). Multiple linear regression analysis was applied to assess the risk factors of language dysfunction in children with BECTS. Results: The total score of language test of C-WISC, and the individual scores, were significantly lower in children with BECTS compared with the scores attained by the healthy controls, and were also significantly lower in children with BECTS with onset earlier than 6 years of age compared with those whose disease onset occurred later. There were no significant correlations between language function and treatment, frequency of seizures, lateralization of centrotemporal spikes, or duration of seizures, but there was a positive correlation between language dysfunction and the age at disease onset. Conclusion: Children with BECTS have language difficulties, especially those with earlier disease onset. Early age at seizure onset is a risk factor for language dysfunction in children with BECTS.

show abstract

Recurrence risk after withdrawal of antiepileptic drugs in children with epilepsy: A prospective study

Cited by 52 publications

References 29 publications

Stopping Antiepileptic Drugs: When and Why?

Stopping Antiepileptic Drugs: When and Why?

Risk of recurrence after discontinuation of antiepileptic drug therapy in children with epilepsy

Language Dysfunction Is Associated with Age of Onset of Benign Epilepsy with Centrotemporal Spikes in Children

Contact Info

Product

Resources

About