Factors predicting the risk of seizure relapse after antiepilepsy drug withdrawal in childhood epilepsy

Abstract

Objective To investigate the factors associated with seizure relapse after antiepilepsy drug (AED) withdrawal in childhood epilepsy. Methods A retrospective analysis was conducted in epileptic children of Hunan Children's Hospital from Jan.2003 to Jan.2011.Among those with anti-epileptic therapy for seizure-free period over 2 years, the patients who relapsed after withdrawal were followed up through outpatient clinic visits and/or by telephone interviews for at least 2 years. Results Of the 127 cases of children enrolled in this study, 28 patients(22.05%) relapsed [male: 12/59 cases(20.34%) and female: 16/68 cases(23.53%)]. Cumulative relapse rates were 18.18%(8/44 cases) in infancy, 15.79%( 6/38 cases) in toddlers, 23.53%(8/34 cases) in preschool children, and 54.55%(6/11 cases)in school age group.Of the patients who relapsed, generalized seizure occurred in 12/87 cases(13.79%), partial seizure in 16/40 cases(40.00%). According to seizure frequency between the first seizure and AED administration, 3 cases(6.25%) relapsed among 48 cases of seizure frequency 0.05). Conclusions Factors associated with an increased risk of relapse are age of epilepsy onset, seizure type, route of administration, timing of antiepileptic drug withdrawal, tapering speed.Standard therapies of early treatment, adherence to medication for at least 3 years, taper period for more than 6 months are associated with a decreased probability for relapse. Key words: Child; Epilepsy; Withdrawal; Relapse