Risk Factors for Seizure Recurrence After Initial Withdrawal of Anti-Seizure Medication in Childhood Epilepsy
Nicholas Odero, Katherine Oyieke, Samson Gwer, Pauline Samia
ABSTRACT TITLE: Risk Factors for Seizure Recurrence After Initial Withdrawal of Anti-Seizure Medication in Childhood Epilepsy OBJECTIVES: To determine risk factors associated with seizure recurrence following withdrawal of anti-seizure medications (ASM) among children with epilepsy. METHODS: This was a retrospective observational study of children aged between 2 and 18 years with a diagnosis of epilepsy who underwent withdrawal of ASM following seizure remission. All eligible medical records between January 2011 and December 2019 were included. Demographic, clinical, imaging and electro-encephalography details of all eligible patients were analyzed against seizure remission within 24 months after withdrawal of ASM, using appropriate parametric and non-parametric tests. RESULTS: A total of 49 records of children who underwent withdrawal of ASM out of a total of 613 patients on follow up during the same period were included. The median age at ASM withdrawal was 70 months (IQR 52-112 months) and 14 (28.6%) were female. Thirteen patients (26.5%) had seizure recurrence within 24 months following withdrawal of ASM. Focal seizure type was associated with significant risk of relapse (OR 13.7; 95% CI 0.97, 193.54; P value = 0.011). Age at epilepsy diagnosis, abnormal EEG at initiation of treatment and before de-escalation, abnormal MRI findings, first or second degree relative with epilepsy, history of developmental delay, seizure burden, use of 2 or more ASMs and duration of seizure-freedom before de-escalation were not associated with increases risk of relapse. CONCLUSION: Focal seizure type is associated with increased with risk of seizure recurrence in our cohort.
Keywords: Epilepsy, risk factors, withdrawal, anti-seizure medications, children
Nicholas Odero
Aga Khan University, Nairobi, Kenya
Kenya
Katherine Oyieke
Aga Khan University , Nairobi, Kenya
Kenya
Samson Gwer
Kenyatta University, Nairobi, Kenya
Kenya
Pauline Samia
Aga Khan University, Nairobi, Kenya.
Kenya
ABSTRACT TITLE: Risk Factors for Seizure Recurrence After Initial Withdrawal of Anti-Seizure Medication in Childhood Epilepsy OBJECTIVES: To determine risk factors associated with seizure recurrence following withdrawal of anti-seizure medications (ASM) among children with epilepsy. METHODS: This was a retrospective observational study of children aged between 2 and 18 years with a diagnosis of epilepsy who underwent withdrawal of ASM following seizure remission. All eligible medical records between January 2011 and December 2019 were included. Demographic, clinical, imaging and electro-encephalography details of all eligible patients were analyzed against seizure remission within 24 months after withdrawal of ASM, using appropriate parametric and non-parametric tests. RESULTS: A total of 49 records of children who underwent withdrawal of ASM out of a total of 613 patients on follow up during the same period were included. The median age at ASM withdrawal was 70 months (IQR 52-112 months) and 14 (28.6%) were female. Thirteen patients (26.5%) had seizure recurrence within 24 months following withdrawal of ASM. Focal seizure type was associated with significant risk of relapse (OR 13.7; 95% CI 0.97, 193.54; P value = 0.011). Age at epilepsy diagnosis, abnormal EEG at initiation of treatment and before de-escalation, abnormal MRI findings, first or second degree relative with epilepsy, history of developmental delay, seizure burden, use of 2 or more ASMs and duration of seizure-freedom before de-escalation were not associated with increases risk of relapse. CONCLUSION: Focal seizure type is associated with increased with risk of seizure recurrence in our cohort.
Keywords: Epilepsy, risk factors, withdrawal, anti-seizure medications, children
Nicholas Odero
Aga Khan University, Nairobi, Kenya
Kenya
Katherine Oyieke
Aga Khan University , Nairobi, Kenya
Kenya
Samson Gwer
Kenyatta University, Nairobi, Kenya
Kenya
Pauline Samia
Aga Khan University, Nairobi, Kenya.
Kenya
Nicholas Odero
Aga Khan University, Nairobi, Kenya Kenya
Aga Khan University, Nairobi, Kenya Kenya