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Discontinuation of antiepileptic drugs after pediatric epilepsy surgery

D Barry Sinclair1, Laura Jurasek, Matt Wheatley

  • 1Comprehensive Epilepsy Program, University of Alberta, Edmonton, Alberta, Canada. barry.sinclair@capitalhealth.ca

Pediatric Neurology
|September 4, 2007
PubMed

Insights

Pediatric epilepsy surgery can lead to antiepileptic drug discontinuation. While less than half of children relapsed after stopping medication, success rates were higher following temporal lobe resection compared to extratemporal lobe surgery.

Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Epileptology

Background:

  • Epilepsy surgery is a recognized treatment for medically intractable seizures in children.
  • Antiepileptic drug (AED) discontinuation after surgery is well-documented in adults but rarely studied in pediatric populations.

Purpose of the Study:

  • To evaluate surgical outcomes and the necessity of AEDs post-surgery in pediatric patients.
  • To compare AED discontinuation rates after temporal lobe resection versus extratemporal lobe resection.

Main Methods:

  • Retrospective review of 80 pediatric patients undergoing epilepsy surgery.
  • Patients were maintained on AEDs for 1 year post-surgery.
  • AED discontinuation was attempted in seizure-free patients with normal electroencephalograms (EEGs) after 1 year.

Main Results:

  • 44% of all patients relapsed after attempting AED discontinuation.
  • Relapse rates were 32% for temporal lobe resections and 55% for extratemporal lobe resections.
  • AED discontinuation success was significantly higher after temporal lobe surgery.

Conclusions:

  • Long-term AEDs are not universally required after pediatric epilepsy surgery.
  • Medication withdrawal is feasible for many children, particularly after temporal lobe resections.
  • Epilepsy surgery offers a potential pathway to reduced or eliminated AED dependence in pediatric patients.

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