Nowa wersja platformy, zawierająca wyłącznie zasoby pełnotekstowe, jest już dostępna.
Przejdź na


Preferencje help
Widoczny [Schowaj] Abstrakt
Liczba wyników
2010 | 5 | 2 | 251-256
Tytuł artykułu

Determination of risk factors associated with seizure relapse after antiepileptic drug withdrawal

Treść / Zawartość
Warianty tytułu
Języki publikacji
There 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.

Opis fizyczny
  • Department of Pediatric Neurology, Gulhane Military Medical Academy, 06018, Etlik, Turkey
  • Department of Pediatric Neurology, Gulhane Military Medical Academy, 06018, Etlik, Turkey
  • Department of Pediatric Neurology, Gulhane Military Medical Academy, 06018, Etlik, Turkey
  • [1] Guerrini R., Epilepsy in children. Lancet, 2006, 367, 499–524[Crossref]
  • [2] Forsgren L., Epidemiology in epilepsy. Epilepsy primarily affects small children and the elderly. Lakartidningen, 1997, 94, 1899–1902
  • [3] Hauser WA., Annegers J.F., Kurland L.T., Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935–1984. Epilepsia, 1993, 34, 453–468[Crossref]
  • [4] Tsuboi T., Prevalence and incidence of epilepsy in Tokyo. Epilepsia, 1988, 29, 103–110[Crossref]
  • [5] Ohta H., Ohtsuka Y., Tsuda T., Oka E., Prognosis after withdrawal of antiepileptic drugs in childhood-onset cryptogenic localization-related epilepsies. Brain Dev., 2004, 26, 19–25[Crossref]
  • [6] Sillanpää M., Remission of seizures and predictors of intractability in long-term follow-up. Epilepsia, 1993, 34, 930–936[Crossref]
  • [7] Holowach J., Thurston D.L., O’Leary J., Prognosis in childhood epilepsy: follow-up study of 148 cases in which therapy had been suspended after prolonged anticonvulsant control. N. Engl. J. Med., 1972, 286, 169–174
  • [8] Aicardi J., Epilepsy in children, second ed., Raven, New York, 1994, 402–428
  • [9] Greenwood R.S., Tennison M.B., When to start and stop anticonvulsant therapy in children. Arch. Neurol., 1999, 56, 1073–1077[Crossref]
  • [10] Emerson R., D’souza B.J., Vining E.P., Holden K.R., Mellits E.D., Freeman J.M., Stopping medication in children with epilepsy. N. Engl. J. Med., 1981, 304, 1125–1129
  • [11] Shinnar S., Berg A.T., Moshe S.L., Discontinuing antiepileptic drugs in children with epilepsy: a prospective study. Annals of Neurology, 1994, 35, 534–545[Crossref]
  • [12] Arts W.F., Visser L.H., Loonen M.C.B., Follow-up of 146 children with epilepsy after withdrawal of antiepileptic drugs. Epilepsia, 1988, 29, 244–250[Crossref]
  • [13] Tennison M., Greenwood R., Lewis D., Thorn M., Discontinuing antiepileptic drugs in children with epilepsy. A comparison of a six-week and a ninemonth taper period. N. Engl. J. Med., 1994, 330, 1407–1410[Crossref]
  • [14] Altunbasak S., Artar O., Burgut R., Yildiztas D., Relapse risk analysis after drug withdrawal in epileptic children with uncomplicated seizures. Seizure, 1999, 7, 384–389[Crossref]
  • [15] Mastropolo C., Tondi M., Carboni F., Manca S., Zoroddu F., Prognosis after therapy discontinuation in children with epilepsy. European Neurology, 1992, 32, 141–145[Crossref]
  • [16] Daoud A.S., Ajloni S., El-Salem K., Horani K., Otoom S., Daradkeh T., Risk of seizure recurrence after a first unprovoked seizure: a prospective study among Jordanian children. Seizure, 2004, 13, 99–103[Crossref]
  • [17] Donati F., Hassink R.I., Jung H., Vassella F., Factors predicting the risk of relapse after antiepileptic drug discontinuation in children with partial seizures. Eur. J. Pediatr., 1995, 154, 44–47[Crossref]
  • [18] Sillanpaa M., Jalava M., Kaleva O., Shinnar S., Long-term prognosis of seizures with onset in childhood. N. Engl. J. Med., 1998, 338, 1715–1722[Crossref]
  • [19] Berg A.T., Shinnar S., Levy S.R., Testa S.M., Testa F.M., Smith-Rapaport S., et al., Two-year remission and subsequent relapse in children with newly diagnosed epilepsy. Epilepsia, 2001, 42, 1553–1562[Crossref]
  • [20] Gross-Tsur V., Shinnar S., Discontinuing antiepileptic drug treatment. In: Wyllie E, editor. The treatment of epilepsy: principles and practice, second ed. Baltimore, MD: Williams and Wilkins. 1996, 799–807
  • [21] Ishiguro Y., Okumura A., Nomura K., Watanabe K., Negoro T., Takada H., et al., A pilot study on benign partial epilepsy in children with complex partial seizures. Seizure, 2001, 10, 194–196[Crossref]
  • [22] Gherpelli J.L., Kok F., dal Forno S., Elkis L.C., Lefevre B.H., Diament A.J., Discontinuing medication in epileptic children: a study of risk factors related to recurrence. Epilepsia, 1992, 33, 681–686[Crossref]
  • [23] Scotoni A.E., Manreza M.L., Guerreiro M.M., Recurrence after a first unprovoked cryptogenic/idiopathic seizure in children: a prospective study from Sao Paulo, Brazil. Epilepsia, 2004, 45, 166–170[Crossref]
  • [24] Boonluksiri P., Risk of seizure recurrence following a first unprovoked seizure in children. J. Trop. Pediatr., 2003, 49, 379–381[Crossref]
  • [25] Pearce J.L., Mackintosh H.T., Prospective study of convulsions in children. N.Z. Med. J., 1979, 89, 1–3
  • [26] Elwes R.D.S., Chesterman P., Reynolds E.H., Prognosis after a first untreated tonic-clonic seizure. Lancet, 1985, 2, 752–753[Crossref]
  • [27] Stroink H., Brouwer O.F., Arts W.F., Geerts A.T., Peters A.C., van Donselaar C.A., The first unprovoked, untreated seizure in childhood: a hospital based study of the accuracy of the diagnosis, rate of recurrence, and long term outcome after recurrence. Dutch study of epilepsy in childhood. J. Neurol. Neurosurg. Psychiatry, 1998, 64, 595–600[Crossref]
  • [28] Berg A.T., Shinnar S., The risk of seizure recurrence following a first unprovoked seizure: a quantitative review. Neurology, 1991, 41, 965–972 [Crossref]
  • [29] Wallis WE., Withdrawal anticonvulsant drug in seizure-free epileptic patient. Clin. Neuropharmacol., 1987, 10, 423–433[Crossref]
  • [30] Berg A.T., Shinnar S., Relapse following discontinuation of antiepileptic drugs: a meta-analysis. Neurology, 1994, 44, 601–608 [Crossref]
  • [31] Shinnar S., Vining E.P., Mellits E.D., D’souza B.J., Holden K., Baumgardner R.A., et al., Discontinuing antiepileptic medication in children with epilepsy after two years without seizers: a prospective study. N. Eng. J. Med., 1985, 313, 976–980[Crossref]
  • [32] Todt H., The late prognosis of epilepsy in childhood: results of a prospective follow-up study. Epilepsia, 1984, 25, 137–144[Crossref]
  • [33] Foorster C., Schmidthberger G., Prognosis in childhood epilepsy after discontinuation of therapy. Monatsschr. Kinderheilkd., 1992, 130, 225–228
  • [34] Joul-Jensen P., Frequency of recurrence after discontinuation of anticonvulsant therapy in patients with epileptic seizures, new follow-up study after 5 years. Epilepsia, 1968, 9, 11–16
Typ dokumentu
Identyfikator YADDA
JavaScript jest wyłączony w Twojej przeglądarce internetowej. Włącz go, a następnie odśwież stronę, aby móc w pełni z niej korzystać.