期刊
EPILEPSIA
卷 64, 期 6, 页码 E93-E97出版社
WILEY
DOI: 10.1111/epi.17594
关键词
drug-resistant epilepsy; drug tapering; drug withdrawal; recurred epilepsy; risk factors
Withdrawal of anti-seizure medication (ASM) is challenging, especially in patients with recurrent seizures. In this observational study, the success rate of ASM withdrawal for a second time in patients with pediatric-onset epilepsy was 41.3%. Factors such as absence of self-limiting epilepsy syndrome, shorter seizure-free intervals before the second withdrawal of ASM, and relapse during tapering after the initial withdrawal of ASM were significantly associated with the success of ASM withdrawal for a second time.
Withdrawal of anti-seizure medication (ASM) is challenging, especially in patients with recurrent seizures. Only limited evidence exists regarding the success rate and recurrence risk factors after withdrawal of ASM for a second time in patients with pediatric-onset epilepsy. In this observational study, we evaluated 104 patients with recurrent pediatric-onset epilepsy who had ASM withdrawn for a second time. The success rate was 41.3% after the second withdrawal of ASM. The absence of a self-limiting epilepsy syndrome, shorter seizure-free intervals before the second withdrawal of ASM, and relapse during tapering after the initial withdrawal of ASM were negative factors significantly associated with the success of ASM withdrawal for a second time. Even after a second seizure recurrence, all patients eventually became seizure-free after restarting their previous ASM (78.7%) or readjusting the ASM (21.3%). Our findings that 40% of patients with recurrent pediatric-onset epilepsy could achieve long-term seizure freedom and that all patients with a second seizure recurrence remained seizure-free suggest that ASM may be withdrawn for a second time after carefully stratifying clinical risk.
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