Effect of the Duration of Withdrawal of Antiepileptic Drugs on the Risk of Seizure Recurrence in Childhood Epilepsy

ABSTRACT Background: There is no consensus on how long the duration of antiepileptic drugs (AEDs) withdrawal after seizure control should be. Some centers recommend very rapid withdrawal while others recommend prolonged tapering. Objective: This study was designed to identify the risk of seizure recurrence after rapid or slow discontinuation of AEDs in epileptic children who are in remission and to assess variables that may modify the risk of recurrence in rapid or slow withdrawal. Methods: One hundred and six epileptic children in remission were included: sixty one of them were subjected to AEDs withdrawal over six months while the remaining forty five patients underwent withdrawal of drugs over three months. All patients were followed up for one year for any new seizure occurs. Results: No significant statistical difference was found between both groups regarding the rate of seizure relapse in one year follow up (P=0.81). It is found that gender, presence of family history of epilepsy, type of seizures, seizure free duration, number of drugs used and type of drugs have no effect on the relapse rate irrespective to the duration of tapering; However, abnormal EEG at withdrawal of therapy was associated with significantly higher relapse rate in the group of three months (rapid) withdrawal. Conclusion: It was concluded that seizure relapse in epileptic children undergoing AEDs withdrawal is not affected by the duration of tapering of treatment apart from children with abnormal EEG in remission who may experience less recurrence rate if 6 months withdrawal is adopted