Is low antiepileptic drug dose effective in long-term seizure-free patients?
Arq. neuropsiquiatr
;
61(3A): 566-573, Sept. 2003. tab, graf
Article
in English
| LILACS
| ID: lil-345769
RESUMO
OBJECTIVE:
To investigate the value of leaving seizure-free patients on low-dose medication.METHOD:
This was an exploratory prospective randomized study conducted at our University Hospital. We evaluated the frequency of seizure recurrence and its risk factors following complete or partial antiepileptic drug (AED) withdrawal in seizure free patients for at least two years with focal, secondarily generalized and undetermined generalized epilepsies. For this reason, patients were divided into two groups Group 1 (complete AED withdrawal), and Group 2 (partial AED withdrawal). Partial AED withdrawal was established as a reduction of 50 percent of the initial dose. Medication was tapered off slowly on both groups. Follow-up period was 24 months.RESULTS:
Ninety-four patients were followed up 45 were assigned to complete (Group 1) AED withdrawal and 49 to partial (Group 2) AED withdrawal. Seizure recurrence frequency after two years follow-up were 34.04 percent in group 1 and 32.69 percent in Group 2. Survival analysis showed that the probability of remaining seizure free at 6, 12, 18 and 24 months after randomization did not differ between the two groups (p = 0.8). Group 1 0.89, 0.80, 0.71 and 0.69; group 2 0.86, 0.82, 0.75 and 0.71. The analysis of risk factors for seizure recurrence showed that more than 10 seizures prior to seizure control was a significant predictive factor for recurrence after AED withdrawal (hazard ratio = 2.73).CONCLUSION:
Leaving seizure free patients on low AED dose did not reduce the risk for seizure recurrence. That is, once the decision of AED withdrawal has been established, it should be complete
Full text:
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Index:
LILACS (Americas)
Main subject:
Epilepsy
/
Anticonvulsants
Type of study:
Controlled clinical trial
/
Diagnostic study
/
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
Arq. neuropsiquiatr
Journal subject:
Neurology
/
Psychiatry
Year:
2003
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
State University of Campinas/BR
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