Success rate of anti-seizure medication discontinuation in children with epilepsy

Abstract

Objective. Epilepsy is a common condition in childhood. Anti-seizure medication (ASM) discontinuation can be considered after two years seizure-freedom. Predictive factors for the success of this withdrawal are needed to simplify the decision-making.

Methods. A literature search was performed to examine the most frequently used predictive variables for risk of recurrence. These 22 variables were then used in a retrospective data search and analysis of 3626 patient files. We focused on those patients seen in 2021 in the epilepsy clinic of the University Hospital of Leuven.

Results. 94 patients between 6 months and 18 years on monotherapy of ASM were included. 21% relapsed after a median of 4 months. Later age at onset of epilepsy, later age at discontinuation and male gender showed a significant effect on the risk of recurrence.

Interpretation. Relapse rate was similar as in existing literature with recurrence occurring more frequently in the first 6 months after discontinuation. Long-lasting epilepsies relapse more frequently. Epilepsy severity, cause and onset are other determinants of recurrence in literature. They were not statistically significant in this study. Further larger prospective studies are needed.