title: Discontinuation of antiepileptic drugs after pediatric epilepsy surgery.
abstract: In children with medically intractable seizures, epilepsy surgery is now a widely accepted option. Successful discontinuation of antiepileptic drugs after epilepsy surgery has been reported in adults, but rarely in children. Surgical outcome and need for antiepileptic drugs after temporal and extratemporal lobe resection were retrospectively reviewed for 80 pediatric patients from the Comprehensive Epilepsy Program at the University of Alberta. For 1 year after surgery, children were maintained on at least one antiepileptic drug. Antiepileptic drug discontinuation was attempted in all patients with a nonepileptic electroencephalogram after 1 year seizure-free. Less than half of the patients (44%) eventually relapsed without antiepileptic drugs. Of the 40 patients in the temporal lobe group, 13 (32%) relapsed without antiepileptic drugs, as did 22 of the 40 extratemporal lobe resection patients (55%). Success rates for antiepileptic drug discontinuation after surgery were higher in the temporal lobe than in the extratemporal lobe group. Long-term antiepileptic drugs are not necessary in all cases, and for many children medication can be withdrawn after epilepsy surgery.
authors.affiliation: Comprehensive Epilepsy Program, University of Alberta, Edmonton, Alberta, Canada. barry.sinclair@capitalhealth.ca
authors.forename: D Barry
authors.initials: DB
authors.lastname: Sinclair
authors.forename: Laura
authors.initials: L
authors.lastname: Jurasek
authors.forename: Matt
authors.initials: M
authors.lastname: Wheatley
authors.forename: Anita
authors.initials: A
authors.lastname: Datta
authors.forename: Donald
authors.initials: D
authors.lastname: Gross
authors.forename: Nizam
authors.initials: N
authors.lastname: Ahmed
authors.forename: Daphne
authors.initials: D
authors.lastname: Quigley
authors.forename: Thomas
authors.initials: T
authors.lastname: Snyder
authors.forename: Keith
authors.initials: K
authors.lastname: Aronyk
authors.forename: John
authors.initials: J
authors.lastname: McKean
mesh_terms: D000293:Adolescent; D038481:Anterior Temporal Lobectomy; D000927:Anticonvulsants / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D004827:Epilepsy / Q000188:drug therapy* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants