Safety of New-generation Antiepileptic Drugs Withdrawal in the Epilepsy Monitoring Unit
Abstract number :
3.066
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2017
Submission ID :
349683
Source :
www.aesnet.org
Presentation date :
12/4/2017 12:57:36 PM
Published date :
Nov 20, 2017, 11:02 AM
Authors :
Chien-Chen Chou, Taipei Veterans General Hospital; Der-Jen Yen, Taipei Veterans General Hospital; Yang-Hsin Shih, Neurological institute, Taipei Veterans General Hospital; Shang-Yeong Kwan, Taipei Veterans General Hospital; Hsiang-Yu Yu, Taipei Veterans G
Rationale: Acute conventional antiepileptic drugs (CAEDs) withdrawal safely and effectively provokes seizures in patients with epilepsy undergoing presurgical video-EEG monitoring. However, the effect of new-generation antiepileptic drugs (NAEDs) withdrawal is still unclear. We conducted this study to compare safety and efficacy between rapid withdrawal of NAEDs and CAEDs in the patients with drug resistant epilepsy (DRE) undergoing presurgical video-EEG monitoring. Methods: In 2015-2017, we enrolled 30 adult patients with diagnosis of DRE who received admission for presurgical video-EEG monitoring. They were classified into two groups: patients having more NAEDs were classified as NAED group and those having more CAEDs were classified as CAED group. We withdrew NAEDs first in the NAED group, and withdrew CAEDs first in the CAED group. All AEDs were discontinued within 1 week. The monitoring was continued until at least 1 habitual seizure was recorded. Results: There were 21 patients in the NAED group and 9 patients in the CAED group. A total of 86 seizures were recorded in the NAED group (mean±SD = 4.1±1.7), compared to 39 seizures recorded in the CAED group (mean ±SD = 4.3±1.3). From start of video-EEG recording to occurrence of 1st seizure, it took 2.43 and 2.94 days in average in the NAED and the CAED groups, respectively. A mean of 5.56 days was required to complete monitoring in the NAED group, compared to 6.63days in the CAED group. There is no significant difference of duration of video-EEG monitoring between two groups (p > 0.5). There were 12 patients in the NAED group (57%) and 3 patients in the CAED group (33%) having cluster seizures. Both groups had no patient with status epilepticus during recording. Conclusions: Both NAEDs and CAEDs withdrawal effectively provoked seizures in patients with DRE undergoing presurgical video-EEG monitoring. Although cluster seizures relatively occurred more in NAEDs withdrawal compared to CAEDs, both NAEDs and CAEDs withdrawal are fairly safe in presurgical video-EEG monitoring. Funding: MOST 105-2314-B-075-016 and MOST 104-2314-B-075-012 from the Taiwan Ministry of Science and Technology.
Neurophysiology