scholarly journals Individualized prediction of seizure relapse and outcomes following antiepileptic drug withdrawal after pediatric epilepsy surgery

Epilepsia ◽  
2018 ◽  
Vol 59 (3) ◽  
pp. e28-e33 ◽  
Author(s):  
Herm J. Lamberink ◽  
Kim Boshuisen ◽  
Willem M. Otte ◽  
Karin Geleijns ◽  
Kees P. J. Braun ◽  
...  
2015 ◽  
Vol 78 (1) ◽  
pp. 104-114 ◽  
Author(s):  
Kim Boshuisen ◽  
Monique M. J. van Schooneveld ◽  
Cuno S. P. M. Uiterwaal ◽  
J. Helen Cross ◽  
Sue Harrison ◽  
...  

Author(s):  
Adil Harroud ◽  
Alexander G. Weil ◽  
Alain Bouthillier ◽  
Dang Khoa Nguyen

Approximately one in three patients with a successful epilepsy surgery will have seizure recurrence following antiepileptic drugs (AED) withdrawal. The value of postoperative testing for predicting seizure relapse after AED tapering is not clear. The purpose of this study was to review the literature for evidence on the use of postoperative investigations before AED discontinuation after successful epilepsy surgery. We were unable to identify studies on the prognostic value of postoperative magnetic resonance imaging and AED blood levels. The literature review yielded seven studies on the predictive value of electroencephalography. Four studies found no association between interictal discharges (IED) and seizure relapse. These studies suffered from various limitations due to their retrospective design and generally small cohorts. Two of the three studies reporting a positive association were prospective and provided strong evidence of an increased risk of seizure recurrence with presence of postoperative IED in successfully operated patients undergoing AED withdrawal.


2011 ◽  
Vol 64 (1-2) ◽  
pp. 25-28
Author(s):  
Marija Knezevic-Pogancev

Introduction. The decision to withdraw antiepileptic drugs is based mostly on a balanced view of the overall risk of seizure relapse and factors most likely to affect that risk. The aim of this study was to find out the patient and family?s attitudes towards the fear of having antiepileptic drug withdrawn, after three years of seizure control. Material and methods. This research was carried out at the Institute for Child and Youth Health care of Vojvodina in Novi Sad. During the study, which lasted from 2003 to 2008, a face-to-face interview about fear of having the antiepileptic therapy withdrawn was done within the adolescent patient examination. The study population included 150 adolescent patients and 265 of their parents. Results. In general, the adolescent patients were ready to accept a significantly higher risk of having recurrences after the antiepileptic drug withdrawal (p<0.05) than their parents. None of their parents was ready to accept the risk 50% higher than the one in the general population. Conclusion. It is important to take into consideration the fear of both adolescent patients and their parents of having recurrences of epileptic seizures before opting for the antiepileptic drug withdrawal.


Open Medicine ◽  
2010 ◽  
Vol 5 (2) ◽  
pp. 251-256 ◽  
Author(s):  
Sebahattin Vurucu ◽  
Mehmet Saldir ◽  
Bulent Unay ◽  
Ridvan Akin

AbstractThere is no consensus regarding the time of antiepileptic drug withdrawal and the relevant risk factors for seizure relapse. In this study, we aimed to determine the seizure relapse rates and the associated risk factors for seizure relapse in childhood epilepsy. Two-hundred sixty-six epileptic patients who discontinued the antiepileptic drug therapy after a seizure-free period of at least two years, were enrolled into the study. The data of the patients regarding sex, febrile convulsion history, family history, age at onset, type of epilepsy, total number of seizures and antiepileptic drugs, seizures during treatment, mental status, first and last electroencephalography, brain imaging findings, etiological factors and seizure relapse in the first two years after antiepileptic drug withdrawal were obtained from the patients’ files. Univariate logistic regression analysis was performed for each variable. The variables which were found to be statistically significant in univariate analysis, were included in multivariate logistic regression analysis. The overall seizure relapse rate after antiepileptic drug withdrawal was 19.2%. There were no significant differences for seizure relapse rate after antiepileptic drug withdrawal between patient groups with respect to sex, family history, type of epilepsy, febrile convulsion history, seizures before treatment, first electroencephalography findings, brain imaging findings and etiology. However, there were statistically significant differences for seizure relapse rate among patient groups concerning age at onset of epilepsy, new seizure during treatment, the total number of antiepileptic drugs, mental status, and last electroencephalography findings. We imply that the clinical status of the patients should be considered before the cessation of drug therapy rather than the etiological factors or laboratory findings.


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