FACTORS PREDICTING THE RISK OF RELAPSE AFTER ANTIEPILEPTIC DRUG DISCONTINUATION IN CHILDREN WITH PARTIAL SEIZURES

The purpose of this study is to identify possible factors which could influence the seizure recurrence after anti-epileptic drug (AED) withd rawal in children with partial epilepsy. AED was discontinued in 82 ch ildren who had been free of partial epileptic seizures for 2.0-11.0 ye ars (mean 4.7 years). Twenty-four patients (29.3%) had a relapse from a few days to 6.1 years (mean 1.2 years) after AED discontinuation. Si gnificantly more common in children who relapsed were: younger age at beginning of AED withdrawal, occurrence of complicated febrile convuls ions (5/24 vs 1/58, P < 0.01), abnormal neurological examination (8/24 vs 8/58, P < 0.05), delayed psychomotor development (7/24 vs 7/58, P < 0.05), focal slowing (6/24 vs 3/58, P < 0.01) and focal epileptiform discharges (7/24 vs 6/58, P < 0.05) in the last EEC before AED discon tinuation. Between the two groups no statistical significant differenc es concerning the age at onset of seizures, the duration at AED therap y after the last seizure, the familial occurrence of epilepsy and back ground EEG abnormalities in the last EEG before AED discontinuation we re found. On the basis of EEG, occurrence of febrile convulsions, and neurological and developmental examination it may be possible to predi ct which children have the best chance to remain free of recurrence af ter AED discontinuation.