Withdrawal and Duration of Antiseizure Medication Therapy in Children
Abstract number :
3.342
Submission category :
4. Clinical Epilepsy / 4C. Clinical Treatments
Year :
2024
Submission ID :
217
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Junghye Byeon, MD., PhD. – Korea University College of Medicine
Baik-Lin Eun, MD., PhD. – Korea University College of Medicine
Young Kyu Shim, MD. – Korea University College of Medicine
Donghwa Yang, MD – Korea University College of Medicine
Rationale: Patients with epilepsy are often considered for withdrawal from anti-seizure medications (ASMs) if they have been seizure-free for at least two years. In pediatric epilepsy, the decision to withdraw medications is made cautiously, depending on individual conditions such as the type of epilepsy syndrome, the occurrence of breakthrough seizures, and the stigma associated with epilepsy in school settings. This study aims to analyze the duration of ASM use and the recurrence of seizures after withdrawal in children and adolescents.
Methods: This retrospective study reviewed the medical records of patients under 18 years of age diagnosed with epilepsy between March 2013 and May 2024 in a tertiary hospital. Patients with no significant brain lesions who had been on ASM for at least two years were included. Withdrawal success was defined as being seizure-free for at least one year after stopping the medication.
Results: A total of 228 patients were analyzed, focusing on type of epilepsy, the number and duration of ASM used, the age of the first seizure, and recurrence after ASD withdrawal. The age at first seizure was significantly younger in the focal epilepsy group (7.6±4.7 years) compared to the generalized epilepsy group (9.4±4.2 years, P=0.029). The number of ASDs was higher in the combined generalized and focal epilepsy group (2.86±1.99) compared to the focal epilepsy group (1.65±1.09) and the generalized epilepsy group (1.86±0.99, P=0.043). The average duration of ASD use was not significantly different among the groups: focal, generalized, combined epilepsy, 49.8, 63.6, and 68.6 months, respectively. The recurrence rates after ASD withdrawal were not significantly different among the groups: 37%, 37%, and 38%, respectively. The withdrawal fail group had a significantly higher number of ASMs (2.14 vs. 1.63, P< 0.01) and a longer duration of use (105.69 vs. 23.95 months, P< 0.01) than the withdrawal success group.
Conclusions: This study showed similar recurrence rates after withdrawal to previous research through a long-term 10-year observational study. Although this study includes self-limiting epilepsy in children, it also includes children on medication, which might explain no significant differences in recurrence rates among different types of epilepsy.
Funding: none
Clinical Epilepsy