A Follow-Up Study after Discontinuation of Antiepileptic Drug Therapy in Children with Well-Controlled Epilepsy: The Factors that Influence Recurrence
Journal of the Korean Pediatric Society
;
: 1559-1570, 2002.
Article
in Korean
| WPRIM
| ID: wpr-44858
ABSTRACT
PURPOSE:
There has been no exact answer to the question of when to discontinue antiepileptic drugs(AEDs) in children with well-controlled epilepsy for a long period. This study is about the risk factors of relapse after withdrawal of AEDs in seizure(Sz)-free patients to show a guideline for discontinuation of AEDs.METHODS:
One hundred and sixty-nine children were diagnosed as epileptic at the Pediatric Dept.of Kyung-Hee Univ. between 1993 to 1998, in whom AEDs had been withdrawn after at least two years of Sz-free period. Univariate analysis using Kaplan-Meier survival analysis and multivariate analysis using Cox-proportional hazard model were performed for sixteen risk factors.RESULTS:
Forty-nine of the 169 patients(28.9%) had recurrence of Szs. The mean follow-up after withdrawal of AEDs was 4.1 years, mean treatment period was 4.1 years, and the mean Sz-free period was 3.3 years. Factors associated with an increased risk of relapse were young age at onset, symptomatic Sz, Sz type in West and Lennox-Gastaut syndrome, neurologic deficit, longer Sz-controlling period, shorter total treatment period, number of AEDs used(more than one drug), age at withdrawal of AEDs, and Sz-free period less than two years in univariate analysis using Kaplan-Meier mothod. From multivariate analysis, the factors indicating a significantly higher relapse risk were pre-treatment period after first Sz attack, Sz-controlling period, Sz-free period, number of AEDs used, neurologic abnormalities.CONCLUSIONS:
For epileptic children who were Sz-free for more than two years, and were more than six-years-old, the discontinuation of AEDs should be considered positively, according to age of onset, Sz type, age at withdrawal of AEDs, total treatment period, Sz-controlling period, number of AEDs used, etiology, neurologic deficit, and the wishes of the patients and the their parents.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Parents
/
Recurrence
/
Proportional Hazards Models
/
Multivariate Analysis
/
Risk Factors
/
Follow-Up Studies
/
Age of Onset
/
Drug Therapy
/
Epilepsy
/
Anticonvulsants
Type of study:
Etiology study
/
Practice guideline
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Child
/
Humans
Language:
Korean
Journal:
Journal of the Korean Pediatric Society
Year:
2002
Type:
Article
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