Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2023 Jun;64(6):e93-e97.
doi: 10.1111/epi.17594. Epub 2023 Apr 7.

Outcomes of the second withdrawal of anti-seizure medication in patients with pediatric-onset epilepsy

Jaeso Cho  1 , Hunmin Kim  2 , Jong Hee Chae  1   3 , Ki Joong Kim  1 , Byung Chan Lim  1
Affiliations
Observational Study

Outcomes of the second withdrawal of anti-seizure medication in patients with pediatric-onset epilepsy

Jaeso Cho et al. Epilepsia. 2023 Jun.

Abstract

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 In this observational study, we evaluated 104 patients with recurrent pediatric-onset epilepsy who had ASM withdrawn for a second time.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seizure freedom and that all patients with a second seizure recurrence remained seizure-free suggest that ASM may be withdrawn for a second time after carefully stratifying clinical risk.

Keywords: drug tapering; drug withdrawal; drug-resistant epilepsy; recurred epilepsy; risk factors.

PubMed Disclaimer

References

REFERENCES

    1. Lamberink HJ, Otte WM, Geleijns K, Braun KP. Antiepileptic drug withdrawal in medically and surgically treated patients: a meta-analysis of seizure recurrence and systematic review of its predictors. Epileptic Disord. 2015;17(3):211-28.
    1. Lamberink HJ, Otte WM, Geerts AT, Pavlovic M, Ramos-Lizana J, Marson AG, et al. Individualised prediction model of seizure recurrence and long-term outcomes after withdrawal of antiepileptic drugs in seizure-free patients: a systematic review and individual participant data meta-analysis. Lancet Neurol. 2017;16(7):523-31.
    1. Braathen G, Anderson T, Gylje H, Melander H, Naglo AS, Noren L, et al. Comparison between one and three years of treatment in uncomplicated childhood epilepsy: a prospective study. I. Outcome in different seizure types. Epilepsia. 1996;37(9):822-32.
    1. McCarthy AL, Camfield CS, Camfield PR, Valencia I. What do epileptologists recommend about discontinuing antiepileptic drugs for a second time in children? Epilepsy Behav. 2015;47:120-6.
    1. Specchio N, Wirrell EC, Scheffer IE, Nabbout R, Riney K, Samia P, et al. International league against epilepsy classification and definition of epilepsy syndromes with onset in childhood: position paper by the ILAE task force on nosology and definitions. Epilepsia. 2022;63(6):1398-442.

Publication types

Substances