Relapse risk analysis after drug withdrawal in epileptic children with uncomplicated seizures

In an attempt to find the risk of relapse and factors predictive of risk of relapse, 97 children with epilepsy, withdrawn from their medication, followed in our outpatient clinic from 1990 to 1995 were included in this study. The overall relapse rate was 20.6%. All relapses occurred within 2 years after withdrawal started. Female gender, age at onset of seizures of more than 2 years, and the duration of withdrawal were found to be significant risk factors in relapse rate following univariate analysis. However, gender was not found to be significant in multivariate analysis. All other factors, including the duration of seizures prior to starting antiepileptic drug (AED) treatment, the number of seizure before the start of AED treatment, the period between AED induction and control of seizures, diagnostic yield from electroencephalogy (EEG) at diagnosis, the number of seizures after the onset of AED therapy, length of seizure-free period, aetiology of the seizures, a history of epilepsy in the immediate family, or previously experienced febrile convulsions were not significant factors in relapse rate. Significant risk factors for relapse rate also significantly affected relapse time. We conclude that when AED therapy is withdrawn from children with uncomplicated epilepsy, as in our patients, the two important risk factors, age at onset of seizures and the duration of withdrawal, can predict a poor prognosis with a higher relapse rate: this needs taking into consideration.