Discontinuation of medications after successful epilepsy surgery in children

Pediatric Neurology
Deepak K LachhwaniE Wyllie

Abstract

To evaluate the need for antiepileptic drugs after successful epilepsy surgery in pediatric patients, we retrospectively reviewed patients who had epilepsy surgery and were seizure free or had rare nondisabling auras during the first 6 postoperative months. Association between drug discontinuation and seizure recurrence was evaluated using Cox proportional hazards multivariable survival analysis. Medications were withdrawn in 68 of 97 patients, seizure free (or with rare nondisabling auras) for >6 months after surgery; 57 of the 68 (84%) remained seizure free; the other 11 (16%) had seizure recurrence after 68 months (median). Seizure recurrence was controlled with medication in 7 of the 11 patients (3 have rare seizures, 1 frequent auras). Discontinuing medications at <6 mo, compared with later or no withdrawal, had significant risk for seizure recurrence (hazard ratio 5.8; 95% confidence interval 1.8, 17.5; P = 0.003). Of 29 patients who continued drugs, 28 (97%) remained seizure free after 37 months (median). Freedom from seizures 6 months after surgery predicted good outcome (95% seizure free, with or without medication). If discontinuation is offered after 6 months, the majority of patients (84%) can be expected to remain ...Continue Reading

References

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Citations

Oct 13, 2009·Pediatric Neurology·Kim BoshuisenOnno van Nieuwenhuizen
Jun 24, 2009·Epilepsy & Behavior : E&B·Frank KerlingHermann Stefan
Oct 31, 2014·Annals of Clinical and Translational Neurology·Ruta YardiLara E Jehi
Mar 13, 2014·Epilepsy Research·Lady D LadinoJosé F Téllez-Zenteno
Jun 23, 2015·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Lakshmi NagarajanSoumya Ghosh
Apr 8, 2016·Expert Review of Neurotherapeutics·Stefano StagiAlberto Verrotti
Jun 1, 2014·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Adil HarroudDang Khoa Nguyen
Apr 30, 2016·Journal of Neurosurgery. Pediatrics·Benoit JennyKarl Schaller
Aug 2, 2018·Acta Neurologica Scandinavica·Ashalatha RadhakrishnanRavi Prasad Varma
Aug 17, 2012·Neurosurgery·Jason S HauptmanGary W Mathern
May 1, 2018·Neurology. Clinical Practice·Luca BartoliniMohamad Z Koubeissi
Feb 22, 2014·Current Opinion in Neurology·Kees P J Braun, Dieter Schmidt
Jan 8, 2018·Journal of Neurology·Barbara SchmeiserAndreas Schulze-Bonhage
Jun 20, 2019·Frontiers in Neurology·Chunbo Zhang, Patrick Kwan
Mar 5, 2021·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Tasneem F Hasan, William O Tatum
Jul 29, 2015·Seizure : the Journal of the British Epilepsy Association·Gudrun GröppelMartha Feucht
Jun 30, 2021·Seminars in Pediatric Neurology·Erin M Fedak Romanowski

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