title: Can electroencephalograms provide guidance for the withdrawal of antiepileptic drugs: A meta-analysis.
abstract: OBJECTIVE
  The discontinuation of antiepileptic drugs (AEDs) is an important treatment decision for epilepsy patients who have been seizure-free for 2years or longer. Some patients experience seizures relapse after AED withdrawal. The prognostic value of electroencephalograms (EEGs) for seizure relapse following AED withdrawal is controversial. To our knowledge, this is the first meta-analysis to address whether EEG data can be used to guide the discontinuation of AEDs.
  
  
  METHODS
  We performed a meta-analysis of cohort studies that reported original EEG data from before AED withdrawal and recurrence after AED-withdrawal. The quality of each study was assessed using the Newcastle-Ottawa Scale.
  
  
  RESULTS
  Fifteen studies including a total of 2349 participants were included in this meta-analysis. This meta-analysis of 15 studies demonstrates that an abnormal electroencephalogram was a predictor of the risk of relapse. Additionally, paroxysmal, slowing, spike and wave activities on electroencephalograms were associated with increased risk of relapse.
  
  
  CONCLUSIONS
  We reveal that abnormal EEG records, particularly paroxysmal abnormalities, before AED withdrawal predicted a high risk of relapse. Slowing and spike and wave activities also exhibited moderate predictive values.
  
  
  CONCLUSIONS
  Our findings suggest that, EEGs might be an important prognostic tool for antiepileptic drug reduction.
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, China; Department of Neurology, The Third Hospital of MianYang, China.
authors.forename: Liwei
authors.initials: L
authors.lastname: Tang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, China. Electronic address: xiaozhengcqmu@126.com.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Xiao
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D000066491:Clinical Decision-Making; D004334:Drug Administration Schedule; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000927:Anticonvulsants
keywords: EEG; Electroencephalogram; Epilepsy; Recurrence; Relapse; Withdrawal