June 9, 2020

Prediction of the Recurrence Risk in Patients with Epilepsy After the Withdrawal of Antiepileptic Drugs

Abstract, published in Epilepsy and Behavior

Many seizure-free patients who consider withdrawing from antiepileptic drugs (AEDs) hope to discontinue treatment to avoid adverse effects. However, withdrawal has certain risks that are difficult to predict.

In this study, researchers performed a literature review, summarized the causes of significant variability in the risk of post-withdrawal recurrent seizures, and reviewed study data on the age at onset, cause, types of seizures, epilepsy syndrome, magnetic resonance imaging (MRI) abnormalities, epilepsy surgery, and withdrawal outcomes of patients with epilepsy. Many factors are associated with recurrent seizures after AED withdrawal. For patients who are seizure-free after treatment, the role of an electroencephalogram (EEG) alone in ensuring safe withdrawal is limited.

A series of prediction models for the post-withdrawal recurrence risk have incorporated various potentially important factors in a comprehensive analysis. This study focused on the populations of studies investigating five risk prediction models and analyzed the predictive variables and recommended applications of each model, aiming to provide a reference for personalized withdrawal for patients with epilepsy in clinical practice.

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