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Updated: Feb 1, 2026

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
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Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy

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Antiseizure medication discontinuation in pediatric epilepsy: Real-world insights

Deniz Menderes1, Salih Akbaş2, Esra Serdaroğlu3

  • 1Department of Pediatric Neurology, Ankara Etlik City Hospital, Ankara, Türkiye.

Epilepsy Research
|January 30, 2026
PubMed

Insights

Antiseizure medication discontinuation in children often results from persistent seizures or psychiatric side effects. Specific drugs like levetiracetam and carbamazepine show distinct adverse event patterns, necessitating individualized treatment.

Area of Science:

  • Pediatric Neurology
  • Epilepsy Management
  • Pharmacovigilance

Background:

  • Antiseizure medications (ASMs) are crucial for managing pediatric epilepsy.
  • Understanding reasons for ASM discontinuation is vital for optimizing treatment outcomes.
  • Drug-specific adverse event profiles influence treatment choices and adherence.

Purpose of the Study:

  • To identify key factors leading to antiseizure medication discontinuation in pediatric epilepsy patients.
  • To characterize drug-specific adverse event patterns associated with monotherapy and polytherapy regimens.

Main Methods:

  • Retrospective analysis of pediatric epilepsy patients (<18 years) from a single clinic (Jan 2015-Sep 2024).
  • Data collection included demographics, epilepsy type, ASM regimen, treatment duration, and discontinuation reasons (inadequate efficacy or adverse effects).

Main Results:

  • ASM discontinuation occurred in 4% (169/4578) of pediatric patients, with higher rates in polytherapy (5%) vs. monotherapy (3%).
  • Primary reasons for discontinuation were persistent seizures (28%) and psychiatric adverse effects (24%).
  • Levetiracetam was linked to psychiatric issues (74%), while carbamazepine correlated with continuous spikes and waves during sleep (CSWS)-like patterns (67%).

Conclusions:

  • Persistent seizures and psychiatric adverse effects are leading causes of ASM discontinuation in children.
  • Specific drug-ASM correlations (levetiracetam-psychiatric, carbamazepine-CSWS-like EEG) underscore the need for individualized ASM selection.
  • Close clinical and electroencephalographic monitoring is essential in pediatric epilepsy management.
Abstract

Keywords:
Adverse effectsAntiseizure medicationsDrug discontinuationPediatric epilepsy

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