Treatment and Discontinuation of Antiepileptic Drugs in Childhood Epilepsy: A Clinical and Electroencephalographic Study Key Words: antiepileptic drugs, discontinuation, childhood epilepsy, treatment, EEG. Yoko Ohtsuka Department of Pediatrics, and Department of Developmental Neuroscience and Child Neurology, Institute for Neurobiology, Okayama University Medical School, Okayama
Table 1 Patients Table 2 Seizure-free period and prognosis after discontinuation ( ) shows percentages,[ ] shows the number of cases whose EEGs were examined after discontinuation
Table 3 Spike-free period and prognosis after discontinuation a) b) ( ) shows percentages,[ ] shows the number of cases whose EEGs were examined after discontinuation
Table 4 Seizure-free period, spike-free period and prognosis after discontinuation Table 5 Prognosis in the cases free from clinical seizures for over three years at the time of drug withdrawal ( ) shows percentages,[ ] shows the number of cases whose EEGs were examined after discontinuation
Table 6 Seizure type at initial visit and prognosis after discontinuation Table 7 Change of seizure types and prognosis after discontinuation of cases whose EEGs were examined after discontinuation
Table 8 Interval between the disontinuation and relapse of seizures shows one case without epileptic discharge at the time of drug withdrawal shows one case with epileptic discharge at the time of drug withdrawal
Table 9 Epileptic discharge and prognosis after discontinuation
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in the former group, 2.1%, than the latter group, 21.1%. Concerning the seizure-free period, the group of cases free from clinical seizures for over three years by the time of withdrawal showed significantly lower relapse rate than the rest of the cases. Since the relapse of clinical seizures was related to both the snike-free perind and the seizure-free period, the interrelationship between these factors was studied further - more. As the result the spike-free period proved to be a more reliable indirator for stopping medication than the seizure-free period. From these findings, the withdrawal of antiepileptic drugs should be started after suppression of epileptic discharges for over two years in childhood epilepsy. However, since each epileptic patient is based on different pathophysiology and etiology, the discontinuation of antiepileptic drugs should be determined not only electroencephalographically, but also taking various clinical factors into consideration comprehensively. J. Jpn. Epil. Soc. 1984; 2: 122-133