Premium
Seizure recurrence after reduction of an antiepileptic drug in patients with unprovoked seizures and severe neurological abnormalities
Author(s) -
Kimura Masahiko,
Yoshino Kunio,
Suzuki Norido
Publication year - 2000
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1046/j.1440-1819.2000.00635.x
Subject(s) - pediatrics , epilepsy , medicine , antiepileptic drug , neurological disorder , prospective cohort study , age of onset , central nervous system disease , anesthesia , surgery , psychiatry , disease
A prospective study of antiepileptic drug (AED) reduction in patients with unprovoked seizures and severe neurological abnormalities after a seizure‐free period of more than 5 years was performed. From a hospital for severely handicapped children (150 patients) and an institution for mentally handicapped people (89 persons), 13 patients were enrolled to this study after informed consent was obtained. All patients had experienced a seizure‐free period of more than 7 years (median, 10 years). The patients had IQs of less than 50 and were almost dependent in their life. Five patients had additional motor deficits. The patients had been taking one to three AED (mean, 1.9) before reduction and only one AED was withdrawn. During the following 2 years, four of the 13 patients (31%) showed a recurrence of seizures. The age at the time of the last seizure was lower in the seizure‐free patients. As to the 10 patients with onset ages of 10 or less, a significant factor as to seizure recurrence was whether or not seizures were controlled before the age of 11 years ( P < 0.05, Fisher’s exact probability test). It is suggested that a patient with severe neurological abnormalities, in whom epilepsy or unprovoked seizures are controlled before the age of 11 years (i.e. before adolescence) could be a candidate for the reduction of AED.