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Discontinuing medication in epileptic children: a study of risk factors related to recurrence

J L Gherpelli1, F Kok, S dal Forno

  • 1Department of Neurology, Clinics Hospital University of Sao Paulo Medical School, Brazil.

Epilepsia
|July 1, 1992
PubMed

Insights

In children with epilepsy seizure-free for 2 years, discontinuing antiepileptic drugs (AEDs) is safer if specific risk factors for seizure recurrence are absent. This approach helps identify children who can safely stop AED treatment.

Area of Science:

  • Neurology
  • Pediatric Epilepsy

Background:

  • Epilepsy affects many children, with treatment often involving long-term antiepileptic drug (AED) use.
  • Discontinuing AEDs in children who have been seizure-free requires careful consideration of recurrence risks.

Purpose of the Study:

  • To identify risk factors for seizure recurrence in children with epilepsy after a period of seizure control.
  • To evaluate the safety of discontinuing AEDs in pediatric epilepsy based on identified risk factors.

Main Methods:

  • A cohort of 70 children with a history of seizures before age 12, seizure-free for at least 2 years, were studied.
  • Recurrence of seizures after AED discontinuation was monitored, and associated risk factors were analyzed.

Main Results:

  • Twenty children (28.5%) experienced seizure recurrence, primarily during or shortly after AED discontinuation.
  • Key risk factors for recurrence included a history of >10 seizures, abnormal EEG, focal neurological signs, mental retardation, and mixed seizure patterns.
  • Children with two or more risk factors were more likely to experience recurrence.

Conclusions:

  • Selected pediatric epilepsy patients seizure-free for at least 2 years may safely discontinue AEDs.
  • The presence or absence of specific risk factors can guide decisions on AED discontinuation in children.

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