Seizure relapse following medication withdrawal in childhood epilepsy

Hindley, Daniel; Staniforth, Harriet

doi:10.1136/adc.2010.199455

Cited by 4 publications

(5 citation statements)

References 3 publications

(3 reference statements)

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“…Reported rates have varied from 16% to 56% in other studies. [1234711] Recurrences occurred mostly in the first 2 years in our patients. In previous studies, 85-90% of recurrences were also reported within 2 years.…”

Section: Discussionmentioning

confidence: 67%

“…[10] In another study, Hindley and Staniforth reported recurrence rate as 32.4% and that cumulative relapse rates were 53.3% of children within 6 months, 66.7% during the 1 st year and 90% within 3 years in their study. [11]…”

Section: Discussionmentioning

confidence: 99%

“…[21011] However, there is still no consensus concerning the conditions for discontinuation of AED in children. Therefore, this study was designed to identify the risk factors associated with recurrence after AED withdrawal in children with epileptic seizures.…”

Section: Introductionmentioning

confidence: 99%

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Risk of recurrence after discontinuation of antiepileptic drug therapy in children with epilepsy

et al. 2014

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Objectives:The numerous antiepileptic drug (AED) withdrawal studies published in the last 40 years have relied mainly on heterogeneous study groups. There is still no general agreement on the criteria to predict safe discontinuation. The goal of this study was to assess the outcome of AED withdrawal in epileptic children.Materials and Methods:Three hundred and eight children with epilepsy were enrolled, and these patients followed at least 1 year after drug withdrawal. Time to seizure relapse and predictive factors were analyzed by survival methods.Results:Among the 308 patients, 179 (58.1%) were boys and 129 (41.9%) were girls and the mean age at the seizure onset was 60.41 ± 36.54 months (2-144 months). The recurrence occurred in 73 (23.7%) patients. Mental retardation, history of febrile seizure, etiological of epilepsy, abnormal first electroencephalogram (EEG), abnormal neuroimaging findings, and total number of AED before remission were significantly associated with relapse risk according to univariate analysis. In the multivariate analysis, abnormal first EEG and number of AED before remission (polytherapy) were the risk factors influencing seizure recurrence.Conclusions:In our study, recurrence rate was 23.7% in children and most occurred during the 1st year. The potential risk factors of recurrence are history of febrile seizure, mental retardation, etiological of epilepsy, abnormal first EEG, abnormal neuroimaging findings, and total number of AED before remission. However, we found abnormal first EEG and polytherapy as risk factors of recurrence in multivariate analysis.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

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Risk of recurrence after discontinuation of antiepileptic drug therapy in children with epilepsy

et al. 2014

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“…When considering the time elapsed between medication withdrawal and seizure recurrence, 23.3% relapsed during weaning or within a month of medication discontinuation. Cumulative relapse rates were 53.3% of children within 6 months, 66.7% during the first year, and 90% within 3 years (23). A recent official report from the International League Against Epilepsy (ILAE) suggests that before starting treatment, it is imperative that the diagnosis of epilepsy be definite.…”

Section: Discussionmentioning

confidence: 99%

Application of a Head-Up Tilt Table Test in Differentiation Between Epilepsy and Syncope in Children

et al. 2022

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Background: Distinguishing between seizure and neurally mediated syncope is challenging because of similar consequences and medical history. A head-up tilt test (HUTT) is a non-invasive, simple, and easy test to distinguish between epilepsy and syncope besides detailed history taking. Objectives: This study aimed to differentiate between epileptic events and reflex syncope (any different type of syncope) using the head-upright tilt test. Methods: We studied 59 patients (37 boys and 22 girls) between 4 to 18 years old (mean age, 10.5 ± 3.7 years) with a previous diagnosis of seizure who did not respond well to treatment. All patients underwent HUTT, and the test was positive in 26 patients. There were no significant differences in sex, age, provocative factors, associated syndrome, and family history between negative and positive groups. Results: There was a history of actual syncope in 26.9% of the positive tilt test group compared to 15.15% of the negative test group. Also, there was a positive family history of syncope in the positive tilt test group. Among 26 patients with a positive tilt test, 17 were diagnosed with vasovagal syncope (VVS) vasodepressor type and 9 with mixed type. Antiepileptic drugs were tapered for patients diagnosed with VVS, and they did not show any seizures after 18 ± 6 months of follow-up. Overemphasizing positive family history and inattention to history taking are 2 crucial factors leading to the misdiagnosis of epilepsy. Conclusions: Our study showed that HUTT is a non-invasive test that can be useful, especially for early and proper diagnosis in children with refractory epilepsy.

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“…There have been many studies for determining the risk factors affecting failure to respond to the initially prescribed AED in epileptic children in literature. [ 8 9 ] Reported rates have varied from 16% to 56% in the literature. [ 9 ] Furthermore, in children with epilepsy, if the initial AED fails to control seizures, the prognosis for seizure control is often thought to be poor.…”

Section: Discussionmentioning

confidence: 99%

First-drug treatment failures in 42 Turkish children with idiopathic childhood occipital epilepsies

İncecik

Hergüner

Altunbaşak

2015

Journal of Neurosciences in Rural Practice

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Background:The early and late benign occipital epilepsies of childhood (BOEC) are described as two discrete electro-clinical syndromes, eponymously known as Panayiotopoulos and Gastaut syndromes. The purpose of this study was to identify predictors of failure to respond to the initial antiepileptic drug (AED).Materials and Methods:A total of 42 children with BOEC were enrolled. Predictive factors were analyzed by survival methods.Results:Among the 42, 25 patients (59.5%) were boys and 17 (40.5%) were girls and the mean age at the seizure onset was 7.46 ± 2.65 years (4–14 years). Of the 42 patients, 34 (81.0%) were treated relatively successfully with the first AED treatment, and 8 (19.0%) were not responded initial AED treatment. There was no correlation between response to initial AED treatment and sex, consanguinity, epilepsy history of family, age of seizure onset, frequency of seizures, history of status epilepticus, duration of starting first treatment, findings on electroencephalogram. However, history of febrile seizure and type of BOEC were significantly associated with failure risk.Conclusions:Factors predicting failure to respond to the AED were history of febrile seizure and type of BOEC in children with BOEC.

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Seizure relapse following medication withdrawal in childhood epilepsy

Cited by 4 publications

References 3 publications

Risk of recurrence after discontinuation of antiepileptic drug therapy in children with epilepsy

Risk of recurrence after discontinuation of antiepileptic drug therapy in children with epilepsy

Application of a Head-Up Tilt Table Test in Differentiation Between Epilepsy and Syncope in Children

First-drug treatment failures in 42 Turkish children with idiopathic childhood occipital epilepsies

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