Volume 59, Issue 5 (9 2001)
Tehran Univ Med J 2001, 59(5): 56-64 |
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Najafi MR, Tamizi Far B. Drug withdrawal in patients with epilepsy: Prognostic value of the EEG. Tehran Univ Med J 2001; 59 (5) :56-64
URL: http://tumj.tums.ac.ir/article-1-1296-en.html
URL: http://tumj.tums.ac.ir/article-1-1296-en.html
Abstract: (8569 Views)
The use of Antiepileptic drugs (AEDs) in children may be associated with adverse effects especially behavioral and cognitive and teratogenic potential effects. The main propose of this study was to find an answer to the question of which factors in EEG of patients before AED withdrawal could have prognostic role in our decision. We studied 106 children whom their medication had been withdrawn 2 years after their last seizure. Before starting of this, an EEG was recorded and interpreted by an expert neurologist. Many variables such as background activity, focal spike, generalized sharp and spik waves, focal slowing, in comparison with the EEG of patient at the time of diagnosis, and also final result of the trace interpret also examined. Follow-up visits were scheduled every 3 months at least for one year. If seizure relapsed, AEDs was resumed and follow up terminated. The overall probability of remaining seizure free was analyzed as a function of time by Kaplan-Meier survical analysis. Prognostic factors affecting seizure relapse were evaluated by using the log-rank test. The overall probability of seizure recurrences was 24.8 percent (95 percent C.I, 22.5 to 28.5) at 12 months. EEG comparisons with previous times were a significant factor for prediction of relapses. Relative risk of this factor was about 1.98 (95 percent C.I, 1.01 to 3.91) (P<0.05). We found that EEG interpretation at the time of diagnosis was not a significant factor but if it divided by sex, there is a significant difference in gender (P=0.06). According to our study the rate of AED withdrawal in children is small. The benefits of continuing AED therapy must be weighted against the risk of potential adverse effects. EEG comparison with previous traces could be evaluated as a prognostic factor before AED withdrawal in children.
Keywords: Electroencephalography, Anticonvulsants, Seizure-remission, Seizure-prognosis, Risk-factors, Survival-analysis
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