Relapse risk analysis after drug withdrawal in epileptic children with uncomplicated seizures

In an attempt to find the risk of relapse and factors predictive of risk of relapse, 97 children with epilepsy, withdrawn from their medication, follo wed in our outpatient clinic from 1990 to 1995 were included in this study. The overall relapse rate was 20.6%. All relapses occurred within 2 years a fter withdrawal started. Female gender, age at onset of seizures of more th an 2 years, and the duration of withdrawal were found to be significant ris k factors in relapse rate following univariate analysis. However, gender wa s not found to be significant in multivariate analysis. All other factors, including the duration of seizures prior to starting antiepileptic drug (AE D) treatment, the number of seizure before the start of AED treatment, the period between AED induction and control of seizures, diagnostic yield from electroencephalogy (EEG) at diagnosis, the number of seizures after the on set of AED therapy, length of seizure-free period, aetiology of the seizure s, a history of epilepsy in the immediate family, or previously experienced febrile convulsions were not significant factors in relapse rate. Signific ant risk factors for relapse rate also significantly affected relapse time. We conclude that when AED therapy is withdrawn from children with uncompli cated epilepsy, as in our patients, the two important risk factors, age at onset of seizures and the duration of withdrawal, can predict a poor progno sis with a higher relapse rate: this needs taking into consideration. (C) 1 999 BEA Trading Ltd.