AUTHOR=Zhao Yongheng , Ding Hao , Zhao Xiaoyu , Qiu Xiaochang , Li Baomin 

TITLE=Risk factors of recurrence after drug withdrawal in children with epilepsy

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1122827

DOI=10.3389/fneur.2023.1122827

ISSN=1664-2295

ABSTRACT=To evaluate the risk factors for recurrence in pediatric patients with epilepsy following normal antiseizure medications (ASMs) treatment and drug withdrawal. We retrospectively analyzed 80 pediatric patients who received treatment at the Qilu Hospital of Shandong University between January 2009 to December 2019 after at least 2 years of seizure-free and normalized EEG before regular drug reduction. Subjects were each followed up for at least 2 years and divided into the recurrence group and non-recurrence group based on whether relapse occurred. Patients’ clinical information was gathered, and risk variables for recurrence were statistically analyzed. 2 years after discontinuation of drug treatment, 19 patients showed relapses. The recurrence rate was 23.75% and mean time of recurrence was 11.09 ± 7.57 months, where there were 7 (36.8%) women and 12 (63.2%) men. Forty-one pediatric patients were followed up till the 3rd year, out of which 2 (4.9%) cases experienced a relapse. Among the remaining 39 non-relapsed patients, 24 were followed up until the 4th year and no recurrence occurred. After being monitored for more than 4 years, 13 patients experienced no recurrence. The differences in the history of febrile seizures, combined use of 2 or more ASMs, and electroencephalography abnormalities after drug withdrawal between the two groups were statistically significant. The results of the bivariate logistic regression analysis revealed that the following factors are independent risk factors for recurrence after drug withdrawal in epileptic children: history of febrile seizures, combined ASM use, and electroencephalography abnormalities after drug withdrawal. The probability of recurrence following drug cessation may be greatly increased by a history of febrile seizures, concomitant use of 2 or more ASMs, and Abnormal EEG after drug discontinuation The first 2 years following drug discontinuation saw the majority of recurrences, and the rate of recurrence was minimal thereafter.