Outcome after Discontinuation of Antiepileptic Drugs in Well Controlled Epileptic Children - Recurrence and Related Risk Factors

Kim, Hyo Bin; You, Su Jeong; Ko, Tae Sung

Abstract

PURPOSE
There has been no exact criteria established for when to discontinue antiepileptic drugs (AEDs) in epileptic children who had been well controlled for a long period. This study was undertaken to evaluate the recurrence rate and predictive risk factors of relapse after discontinuation of AEDs in epileptic children who had been seizure-free.
METHODS
We retrospectively studied 294 children whose discontinued AEDs therapy was after a long seizure-free period in Asan Medical Center.
RESULTS
Seizure recurred in 59 patients(21.0%) after discontinuation of AEDs. The mean duration of follow-up after discontinuation was 4.0 years for the patients, the mean duration of the medication period was 3.5 years and the mean seizure-free period was 2.8 years. The factors associated with an increasing recurrence risk were old age at onset, long duration of seizure, old age at discontinuation of AEDs and abnormal radiologic findings in univariate analysis. From multivariate analysis, the factors related to higher recurrence rate were old age at onset, long duration of seizure and abnormal radiologic findings.
CONCLUSION
The majority of epileptic children who are older than 10 years, who have developed seizures for longer than six years and who show abnormal radiologic findings will easily relapse. The patients who do not have the additional risk factors noted above may have an excellent chance to remain seizure-free after the discontinuation of AEDs, so patient in the latter group can consider the discontinuation of AEDs.