title: Risk of recurrence after discontinuation of antiepileptic drug therapy in children with epilepsy.
abstract: OBJECTIVE
  The numerous antiepileptic drug (AED) withdrawal studies published in the last 40 years have relied mainly on heterogeneous study groups. There is still no general agreement on the criteria to predict safe discontinuation. The goal of this study was to assess the outcome of AED withdrawal in epileptic children.
  
  
  METHODS
  Three hundred and eight children with epilepsy were enrolled, and these patients followed at least 1 year after drug withdrawal. Time to seizure relapse and predictive factors were analyzed by survival methods.
  
  
  RESULTS
  Among the 308 patients, 179 (58.1%) were boys and 129 (41.9%) were girls and the mean age at the seizure onset was 60.41 ± 36.54 months (2-144 months). The recurrence occurred in 73 (23.7%) patients. Mental retardation, history of febrile seizure, etiological of epilepsy, abnormal first electroencephalogram (EEG), abnormal neuroimaging findings, and total number of AED before remission were significantly associated with relapse risk according to univariate analysis. In the multivariate analysis, abnormal first EEG and number of AED before remission (polytherapy) were the risk factors influencing seizure recurrence.
  
  
  CONCLUSIONS
  In our study, recurrence rate was 23.7% in children and most occurred during the 1(st) year. The potential risk factors of recurrence are history of febrile seizure, mental retardation, etiological of epilepsy, abnormal first EEG, abnormal neuroimaging findings, and total number of AED before remission. However, we found abnormal first EEG and polytherapy as risk factors of recurrence in multivariate analysis.
authors.affiliation: Department of Pediatrics, Division of Pediatric Neurology, Faculty of Medicine, Cukurova University, Adana, Turkey.
authors.forename: Faruk
authors.initials: F
authors.lastname: Incecik
authors.affiliation: Department of Pediatrics, Division of Pediatric Neurology, Faculty of Medicine, Cukurova University, Adana, Turkey.
authors.forename: Ozlem M
authors.initials: OM
authors.lastname: Herguner
authors.affiliation: Department of Pediatrics, Division of Pediatric Neurology, Faculty of Medicine, Cukurova University, Adana, Turkey.
authors.forename: Sakir
authors.initials: S
authors.lastname: Altunbasak
authors.affiliation: Department of Pediatrics, Division of Pediatric Neurology, Faculty of Medicine, Cukurova University, Adana, Turkey.
authors.forename: Gulen
authors.initials: G
authors.lastname: Mert
authors.affiliation: Department of Pediatrics, Division of Pediatric Neurology, Faculty of Medicine, Cukurova University, Adana, Turkey.
authors.forename: Nurcihan
authors.initials: N
authors.lastname: Kiris
keywords: Antiepileptic drug; epileptic children; recurrence risk factors; withdrawal