Risk of recurrence after antiepileptic withdrawal: Was it a good decision or not?

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Yayıcı Köken Ö., Aksoy A., Kucur Ö., Kafalı M.

CURRENT JOURNAL OF NEUROLOGY, vol.20, no.2, pp.78-85, 2021 (ESCI) identifier

  • Publication Type: Article / Article
  • Volume: 20 Issue: 2
  • Publication Date: 2021
  • Doi Number: 10.18502/cjn.v20i2.6743
  • Journal Indexes: Emerging Sources Citation Index (ESCI)
  • Page Numbers: pp.78-85
  • Akdeniz University Affiliated: Yes


The aim of this study was to identify the demographic-clinical variables affecting idiopathic epilepsy (IE) [called genetic generalized epilepsy (GGE)] recurrence and determine cut-off values that can be used in pediatric neurology practice for children with IE/GGE.
Methods: A total of 250 children and adolescents with IE/GGE were included and retrospectively evaluated. The patients’ hospital records were examined in order to identify possible electro-clinical features affecting epilepsy recurrence.
Results: The overall rate of recurrence in the patients was 46%; the age at onset of seizures in recurrence group was lower (P = 0.040) and the age at last seizure was higher in the recurrence group (P < 0.001) than that in the non-recurrence group. Other factors found to be related to recurrence were the shorter duration of the seizure-free period (P = 0.030), shorter interval

between the last seizure and antiepileptic drug (AED) withdrawal (P = 0.003), shorter duration of AED withdrawal (P = 0.005), and the existence of abnormalities on sleep electroencephalogram (EEG) during AED withdrawal (P = 0.010) and at the 6th month of withdrawal (P < 0.001). According to receiver operating characteristic (ROC) analysis, the risk of IE recurrence was higher in children who were younger than 3.6 years old (sensitivity: 65.6%, specificity: 62.7%), children with a seizure-free period that was shorter than 35.5 months (sensitivity: 89.6%, specificity: 32.8%), and children whose drug withdrawal period was shorter than 4.5 months (sensitivity: 56.3%, specificity: 71.6%).

Conclusion: This study defined some electro-clinical factors that could guide clinicians when deciding to withdraw AEDs with regard to recurrence risk after evaluating a homogenous population of children with a diagnosis of IE/GGE.