Risk Factors for Seizure Recurrence after Initial Withdrawal of Anti-Seizure Medications in Children with Epilepsy at Aga Khan University Hospital, Nairobi, Kenya.
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Date
2023
Authors
Odero, Nicholas
Oyieke, Katherine
Gwer, Samson
Samia, Pauline
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier Inc
Abstract
We sought to determine risk factors associated with seizure recurrence following initial withdrawal of anti-seizure medications (ASM) among children with epilepsy.
Methods: This was a retrospective observational study of children aged between 2 and 18 years with a
diagnosis of epilepsy who underwent withdrawal of anti-seizure medication following remission of seizures. All eligible medical records between January 2011 and December 2019 were included.
Demographic, clinical, imaging and electroencephalography data of all eligible patients were analyzed
against seizure remission within 24 months after withdrawal of ASM, using appropriate parametric
and non-parametric tests.
Results: A total of 49 records of children who underwent withdrawal of ASM out of a total of 613 patients
on follow up during the same period were included. The median age at ASM withdrawal was 70 months
(IQR 52–112 months) and 14 (28.6%) were female. Thirteen patients (26.5%) had seizure recurrence
within 24 months following withdrawal of ASM. Focal onset seizure type was associated with significant
risk of seizure recurrence (OR 13.7; 95% CI 0.97, 193.54; P value = 0.011). Age at epilepsy diagnosis,
abnormal EEG at initiation of treatment and at the time of de-escalation, abnormal MRI findings, first
or second degree relative with epilepsy, history of developmental delay, seizure burden, use of 2 or more
ASMs and duration of seizure-freedom before de-escalation of ASM were not associated with increased
risk of relapse.
Conclusion: Focal onset seizure type is associated with increased with risk of seizure recurrence in this
cohort
Description
Article
Keywords
Epilepsy, Anti-seizure medications, Seizure relapse, Children
Citation
Odero, N., Oyieke, K., Gwer, S., & Samia, P. (2023). Risk factors for seizure recurrence after initial withdrawal of anti-seizure medications in children with epilepsy at Aga Khan University Hospital, Nairobi, Kenya. Epilepsy & Behavior Reports, 22, 100596.