[Treatment termination in children with idiopathic generalized epilepsy and cryptogenic focal epilepsy]

Abstract

The regression of epileptic attacks after a period for remission brings hope, particularly for a sick child's parents, for prompt treatment termination. This process, however, is related to the risk that the disease will recur. The paper is about the evolution of these changes in EEG and the assessment of disease recurrence in the course of treatment and upon therapy termination in patients taking valproic acid preparations (VPA) during idiopathic generalized epilepsy (IGE) and those taking carbamazepine (CBZ) preparations during cryptogenic focal epilepsy (CFE). A total of 121 patients in whom the attacks regressed as a result of monotherapy, were subjected to the assessment. The patients were classified into 2 groups: the first group of 52 patients treated with VPA (IGE), patients' age at the beginning of treatment--from 6 to 14, and the second group of 69 patients treated with CBZ (CFE), patients' age at the beginning of treatment--from 5 to 12. In patients suffering from IGE, an absence of attacks prevailed; while in those with CFE--the secondary generalized ones prevailed. The drug dosage reduction lasted from 3 to 24 months. The observation time at treatment termination was 2 years. 10 routine EEG tests were assessed in each patient. Attack regression was achieved mainly within 2 weeks, sporadically up to 6 months. In the initial EEG tests 4 (5.8%) of the patients with partial seizures had normal records, in the remaining 94.2%--the records were abnormal. Throughout the duration of the treatment, systematic improvement of EEG was noted in groups 1 and 2. At the commencement of the dosage reduction, the EEG irregularities were maintained in 9% of the patients with IGE and in 26% of those with CFE, increasing during reduction until the discontinuance of the medication. Frequency of attack recurrences was twice as large in the patients with IGE (mainly after the end of treatment) than in those with CFE, where they occurred during the reduction period and up to 3 months after the end of treatment. The recurrence of the disease in children of the first group was only preceded in one third by irregularities in EEG; on the contrary, it occurred in two thirds of the second group. The morphology of changes was non-homogeneous.