ArticleEpilepsia2021
Prediction of seizure recurrence risk following discontinuation of antiepileptic drugs.
Article in Epilepsia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Reappraisal of the Medical Research Council Antiepileptic Drug Withdrawal Study: Contamination-adjusted and dose-response re-analysis.Epilepsia · 2022Trial
- Development and validation of a deep survival model to predict time to seizure from routine electroencephalography.Epilepsia · 2026Article
- Resveratrol‒loaded self‒assembled tetrahedral framework nucleic acids reshape the epileptic microenvironment by regulating oxidative stress and neuroinflammation via the SIRT3/SOD2 pathway.Journal of nanobiotechnology · 2026Article
- Challenges in antiseizure medication discontinuation decisions: A qualitative study of clinicians who see patients with epilepsy.Clinical neurology and neurosurgery · 2026Article
- Risk factors of recurrence for epilepsy patients after antiseizure medication withdrawal: what we do and do not know?Journal of neurology · 2025Review
- Brain Tumor Related Epilepsy: Pathophysiology and Multimodal Approach to Management.Current oncology reports · 2025Review
- Non-discontinuation of antiseizure medication in seizure-free epilepsy patients.European journal of neurology · 2024Article
- Variation in seizure risk increases from antiseizure medication withdrawal among patients with well-controlled epilepsy: A pooled analysis.Epilepsia open · 2024Article
- Postoperative interictal epileptiform discharges predict seizure recurrence after antiepileptic drug withdrawal regardless of concordance with surgical site.World journal of pediatric surgery · 2024Article
- Predicting seizure recurrence after an initial seizure-like episode from routine clinical notes using large language models: a retrospective cohort study.The Lancet. Digital health · 2023Article
- Frequency of and factors associated with antiseizure medication discontinuation discussions and decisions in patients with epilepsy: A multicenter retrospective chart review.Epilepsia open · 2023Article
- Antiseizure medication withdrawal risk estimation and recommendations: A survey of American Academy of Neurology and EpiCARE members.Epilepsia open · 2023Article
- Video-EEG-monitoring to guide antiseizure medication withdrawal.Neurological research and practice · 2023Article
- Removing artefacts and periodically retraining improve performance of neural network-based seizure prediction models.Scientific reports · 2023Article
- Antiseizure Medication Withdrawal Practice Patterns: A Survey Among Members of the American Academy of Neurology and EpiCARE.Neurology. Clinical practice · 2023Article
- 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 · 2023Article
- Serum Proteins Associated with Blood-Brain Barrier as Potential Biomarkers for Seizure Prediction.International journal of molecular sciences · 2022Article
- Incidence of and predictors for antiseizure medication gaps in Medicare beneficiaries with epilepsy: a retrospective cohort study.BMC neurology · 2022Article
- Recurrence rates and risk factors for seizure recurrence following antiseizure medication withdrawal in adolescent patients with genetic generalized epilepsy.Epilepsia open · 2022Article
- Scalp HFO rates decrease after successful epilepsy surgery and are not impacted by the skull defect resulting from craniotomy.Scientific reports · 2022Article
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Abstract
objectiveDiscontinuation of antiepileptic drugs (AEDs) in seizure-free patients is an important goal because of possible long-term side effects and the social stigma burden of epilepsy. The purpose of this work was to assess seizure recurrence risk after suspension of AEDs, to evaluate predictors for recurrence, and to investigate the recovery of seizure control after relapse. In addition, the accuracy of a previously published prediction model of seizure recurrence risk was estimated.
methodsSeizure-free patients with epilepsy who had discontinued AEDs were retrospectively enrolled. The frequency of seizure relapses after AED withdrawal as well as prognosis after recurrence were assessed and the predictive role of baseline clinical-demographic variables was evaluated. The aforementioned prediction model was also validated and its accuracy assessed at different seizure-relapse probability levels.
resultsThe enrolled patients (n = 133) had been followed for a median of 3 years (range 0.8-33 years) after AED discontinuation; 60 (45%) of them relapsed. Previous febrile seizures in childhood (hazard ratio [HR] 3.927; 95% confidence interval [CI] 1.403-10.988), a seizure-free period on therapy of less than 2 years (HR 2.313; 95% CI 1.193-4.486), and persistent motor deficits (HR 4.568; 95% CI 1.412-14.772) were the clinical features associated with relapse risk in univariate analysis. Among these variables, only a seizure-free period on therapy of less than 2 years was associated with seizure recurrence in multivariate analysis (HR 2.365; 95% CI 1.178-4.7444). Pharmacological control of epilepsy was restored in 82.4% of the patients who relapsed. In this population, the aforementioned prediction model showed an unsatisfactory accuracy. SIGNIFICANCE: A period of freedom from seizure on therapy of less than 2 years was the main predictor of seizure recurrence. The accuracy of the previously described prediction tool was low in this cohort, thus suggesting its cautious use in real-world clinical practice.
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