Early antiseizure medication withdrawal and risk of seizure recurrence in children after epilepsy surgery: A retrospective study

作者全名："Wu, YuXin; Zhang, ZaiYu; Liang, Ping; Zou, Bin; Wang, Difei; Wu, XuanXuan; Zhai, Xuan"

作者地址："Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Childrens Hosp, Dept Neurosurg,Minist Educ,Key Lab Child Dev & Di, Chongqing, Peoples R China; Chongqing Key Lab Translat Med Res Cognit Dev & L, Chongqing, Peoples R China"

通信作者："Zhai, X (通讯作者)，Chongqing Med Univ, Childrens Hosp, 136 Zhongshan 2nd Rd, Chongqing 400010, Peoples R China."

来源：EPILEPSY & BEHAVIOR

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:001127049600001

JCR分区：Q2

影响因子：2.6

年份：2024

卷号：150

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：Epilepsy surgery; Antiseizure medication; Children; Seizure recurrence; Epilepsy

摘要："Objective: The timing of antiseizure medication (ASM) withdrawal in children after epilepsy surgery remains controversial and lacks recognized standards. Given the various negative effects of ASM on development in children, this study aimed to evaluate the safety and feasibility of early ASM withdrawal after epileptic resection surgery.Methods: We retrospectively assessed the seizure outcomes and ASM profiles of children who had undergone epileptic resection surgery between August 2015 and August 2020 and attempted ASM reduction in the early postoperative phase. Tapering the dose of ASM was attempted when children were seizure-free with no interictal epileptiform discharges (IEDs) on electroencephalogram (EEG) for at least 6 months postoperatively.Results: This study included 145 children with a median follow-up duration of 40 months. Early ASM tapering was attempted postoperatively in 99 (68.3 %) children. Postoperative ASM discontinuation was attempted in 87 (60.0 %) children. Nine (9.1 %) children experienced seizure recurrence during the ASM reduction stage, and 10 (11.5 %) experienced recurrence after ASM discontinuation. Incomplete resection (P = 0.003) and postoperative seizures before ASM tapering (P = 0.003) were independent predictors of seizure recurrence during and after early ASM withdrawal.Significance: ASM withdrawal is viable and safe to be initiated in children who are seizure-free postoperatively and have no IEDs on the scalp EEG for at least 6 months. Children with incomplete resection and postoperative seizures before ASM withdrawal are at a higher risk of seizure recurrence and may need to continue ASM for a longer period."

基金机构："National Natural Science Foundation of China [81971217]; Youth Project of National Clinical Research Center for Child Health and Disorders (Children ' s Hospital of Chongqing Medical University, Chongqing, China) [NCRCCHD-2022-YP-12]"

基金资助正文："Supported by the National Natural Science Foundation of China (Grant No. 81971217) and the Youth Project of National Clinical Research Center for Child Health and Disorders (Children ' s Hospital of Chongqing Medical University, Chongqing, China) (Grant No. NCRCCHD-2022-YP-12) . We confirm that we have read the Journal ' s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines."