Withdrawal of antiepileptic therapy in children with partial epileptic seizures

Abstract

Discontinuation of antiepileptic therapy presents a challenge for physicians and patient. Many parameters play a role, and the doctor has to assess the relationship between benefits and any possible damages caused by this act. The final decision should be made with the parents and the patient. In this study, we assessed the role of various factors on the possibility of relapse of epileptic seizures after discontinuation off antiepileptic therapy. We studied a cohort of children with partial epilepsy. Discontinuation was performed from 2001-2007. The study included 93 children divided into groups according to age of diagnosis and the introduction of antiepileptic therapy, the type of seizures, etiology, neurological and psychological status, the results neuroimaging studies, family history, history of febrile seizures, antiepileptic therapy, EEG registration before discontinuation of the treatment, speed of tapering therapy. Multivariable analysis was made, binary logistic regression. Factors that showed statistical significance were: age at the diagnosis, duration of active epilepsy, neurological and psychological status, EEG registration before discontinuation of therapy, the length of the period without seizures before discontinuation of the therapy and length of tapering the therapy.
It is necessary to pay attention to the factors affecting increased risk of relapse of epileptic seizures when discontinuing the antiepileptic therapy in patients with partial epilepsies. This should be discussed with parents and patients, and consensus has to be reached. Doctor and patient must be aware that the risk of recurrence of epileptic seizures is high.