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Cessation of epilepsy therapy in children

Stefano Stagi1, Stefania Lasorella2, Alessandra Piccorossi2

  • 1a Pediatric Endocrinology Unit, Health Sciences Department , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.

Expert Review of Neurotherapeutics
|April 8, 2016
PubMed

Insights

For children with epilepsy, carefully consider discontinuing antiepileptic drugs (AEDs). Key factors like EEG, age, and seizure history help predict relapse risk during AED withdrawal.

Area of Science:

  • Pediatric Neurology
  • Clinical Pharmacology

Background:

  • Epilepsy management in children often involves antiepileptic drug (AED) withdrawal during seizure-free periods.
  • Deciding on AED discontinuation requires careful assessment of seizure relapse risks.

Purpose of the Study:

  • To review literature and identify factors predicting seizure recurrence after AED withdrawal in children.
  • To delineate a therapeutic approach for AED withdrawal in pediatric epilepsy.

Main Methods:

  • Systematic review of existing studies on AED withdrawal in children with epilepsy.
  • Analysis of factors associated with seizure recurrence post-withdrawal.

Main Results:

  • Identified risk factors for seizure relapse include abnormal EEG, early ( < 2 years) or late ( > 10 years) age at onset, defined etiology, and intellectual disability.
  • A seizure-free period of at least 2 years and slow tapering of AEDs are recommended.

Conclusions:

  • Risk stratification is crucial for deciding on AED withdrawal in pediatric epilepsy.
  • Further prospective studies are needed to refine withdrawal strategies and optimize patient outcomes.

Keywords:
EEGEpilepsyantiepileptic drugschildrenpersonal riskrelapseseizure-free periodwithdrawal

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