Risk factors of recurrence after drug withdrawal in children with epilepsy
This study aimed to evaluate the risk factors for recurrence in pediatric patients with epilepsy following normal antiseizure medication (ASM) treatment and drug withdrawal. We retrospectively analyzed 80 pediatric patients who received treatment at the Qilu Hospital of Shandong University between J...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1122827/full |
| _version_ | 1797838628658872320 |
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| author | Yongheng Zhao Yongheng Zhao Hao Ding Hao Ding Xiaoyu Zhao Xiaoyu Zhao Xiaochang Qiu Baomin Li |
| author_facet | Yongheng Zhao Yongheng Zhao Hao Ding Hao Ding Xiaoyu Zhao Xiaoyu Zhao Xiaochang Qiu Baomin Li |
| author_sort | Yongheng Zhao |
| collection | DOAJ |
| description | This study aimed to evaluate the risk factors for recurrence in pediatric patients with epilepsy following normal antiseizure medication (ASM) treatment and drug withdrawal. We retrospectively analyzed 80 pediatric patients who received treatment at the Qilu Hospital of Shandong University between January 2009 and December 2019 after at least 2 years of seizure-free and normal electroencephalography (EEG) before the regular drug reduction. Patients were followed-up for at least 2 years and divided into the recurrence and nonrecurrence groups based on whether relapse occurred. Clinical information was gathered, and the risk variables for recurrence were statistically analyzed. Post 2 years of drug withdrawal, 19 patients showed relapses. The recurrence rate was 23.75%, and the mean time of recurrence was 11.09 ± 7.57 months, where 7 (36.8%) were women and 12 (63.2%) were men. In all, 41 pediatric patients were followed-up until the 3rd year, of which 2 (4.9%) patients experienced a relapse. Among the remaining 39 patients without relapse, 24 were followed-up until the 4th year, and no recurrence occurred. After being monitored for >4 years, 13 patients experienced no recurrence. The differences in the history of febrile seizures, combined use of ≥2 ASMs, and EEG abnormalities after drug withdrawal between the two groups were statistically significant (p < 0.05). Multivariate binary logistic regression analysis revealed that these factors are independent risk factors for recurrence after drug withdrawal in children with epilepsy: history of febrile seizures (OR = 4.322, 95% CI: 1.262–14.804), combined ASM use (OR = 4.783, 95% CI: 1.409–16.238), and EEG abnormalities after drug withdrawal (OR = 4.688, 95% CI: 1.154–19.050). In summary, our results suggest that the probability of seizure recurrence following drug cessation may be greatly increased by a history of febrile seizures, concomitant use of ≥2 ASMs, and EEG abnormalities after drug cessation. The majority of recurrences occurred in the first 2 years following drug discontinuation, whereas the rate of recurrence was minimal thereafter. |
| first_indexed | 2024-04-09T15:45:01Z |
| format | Article |
| id | doaj.art-326bb166f29f47caa6053aaca4e99800 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-09T15:45:01Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-326bb166f29f47caa6053aaca4e998002023-04-27T04:36:46ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-04-011410.3389/fneur.2023.11228271122827Risk factors of recurrence after drug withdrawal in children with epilepsyYongheng Zhao0Yongheng Zhao1Hao Ding2Hao Ding3Xiaoyu Zhao4Xiaoyu Zhao5Xiaochang Qiu6Baomin Li7Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaCheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaCheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaCheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Geriatrics, The First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital), Jinan, ChinaDepartment of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaThis study aimed to evaluate the risk factors for recurrence in pediatric patients with epilepsy following normal antiseizure medication (ASM) treatment and drug withdrawal. We retrospectively analyzed 80 pediatric patients who received treatment at the Qilu Hospital of Shandong University between January 2009 and December 2019 after at least 2 years of seizure-free and normal electroencephalography (EEG) before the regular drug reduction. Patients were followed-up for at least 2 years and divided into the recurrence and nonrecurrence groups based on whether relapse occurred. Clinical information was gathered, and the risk variables for recurrence were statistically analyzed. Post 2 years of drug withdrawal, 19 patients showed relapses. The recurrence rate was 23.75%, and the mean time of recurrence was 11.09 ± 7.57 months, where 7 (36.8%) were women and 12 (63.2%) were men. In all, 41 pediatric patients were followed-up until the 3rd year, of which 2 (4.9%) patients experienced a relapse. Among the remaining 39 patients without relapse, 24 were followed-up until the 4th year, and no recurrence occurred. After being monitored for >4 years, 13 patients experienced no recurrence. The differences in the history of febrile seizures, combined use of ≥2 ASMs, and EEG abnormalities after drug withdrawal between the two groups were statistically significant (p < 0.05). Multivariate binary logistic regression analysis revealed that these factors are independent risk factors for recurrence after drug withdrawal in children with epilepsy: history of febrile seizures (OR = 4.322, 95% CI: 1.262–14.804), combined ASM use (OR = 4.783, 95% CI: 1.409–16.238), and EEG abnormalities after drug withdrawal (OR = 4.688, 95% CI: 1.154–19.050). In summary, our results suggest that the probability of seizure recurrence following drug cessation may be greatly increased by a history of febrile seizures, concomitant use of ≥2 ASMs, and EEG abnormalities after drug cessation. The majority of recurrences occurred in the first 2 years following drug discontinuation, whereas the rate of recurrence was minimal thereafter.https://www.frontiersin.org/articles/10.3389/fneur.2023.1122827/fullepilepsychildrendrug withdrawalrecurrencerisk factors |
| spellingShingle | Yongheng Zhao Yongheng Zhao Hao Ding Hao Ding Xiaoyu Zhao Xiaoyu Zhao Xiaochang Qiu Baomin Li Risk factors of recurrence after drug withdrawal in children with epilepsy Frontiers in Neurology epilepsy children drug withdrawal recurrence risk factors |
| title | Risk factors of recurrence after drug withdrawal in children with epilepsy |
| title_full | Risk factors of recurrence after drug withdrawal in children with epilepsy |
| title_fullStr | Risk factors of recurrence after drug withdrawal in children with epilepsy |
| title_full_unstemmed | Risk factors of recurrence after drug withdrawal in children with epilepsy |
| title_short | Risk factors of recurrence after drug withdrawal in children with epilepsy |
| title_sort | risk factors of recurrence after drug withdrawal in children with epilepsy |
| topic | epilepsy children drug withdrawal recurrence risk factors |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1122827/full |
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