Recurrence of Epilepsy and Related Risk Factors after the Discontinuation of Antiepileptic Drugs in Children: A 10-Year Single-Center Study

Abstract

Purpose The criteria for discontinuing antiepileptic drugs (AEDs) in children with well-controlled epilepsy remain unclear. This study sought to identify the recurrence rate of epilepsy after the discontinuation of AEDs and the risk factors associated with recurrence. Methods We retrospectively reviewed the records of 441 children who discontinued AEDs at our department of pediatrics from August 2007 to July 2017. AED tapering was performed in patients who were seizure-free for more than 2 years after taking AEDs, and patients were monitored for 1 year after the discontinuation of AEDs. Results We found that 87 patients (87/441, 19.7%) experienced seizure recurrence within 1 year after the discontinuation of AEDs. Among them, 38 patients (38/87, 43.7%) experienced recurrence during AED tapering. The recurrence of seizures was related to the patient’s age at AED onset and when seizures were controlled, a history of seizure recurrence after previous discontinuation of AEDs or a seizure episode during AED administration, and no improvement of electroencephalographic (EEG) findings. Conclusion The recurrence rate within 1 year after the discontinuation of AEDs was almost 20%, and nearly half of the recurrences took place during the tapering period. We recommend caution when considering whether to discontinue AEDs in patients with a history of seizure recurrence after AED discontinuation, a seizure episode during AED administration, or no (or slight) improvement of EEG findings.

Keywords

• epilepsy
• recurrence
• child
• risk factors
• anticonvulsants