Evaluating the Rate of Recurrence of Epilepsy after Therapy Discontinuation in 2-Year Seizure-Free Epileptic Patients

ABSTRACT

Introduction: The potential complications of antiepileptic drugs render them risky and associated with numerous morbidities for long-term therapy. Therefore, it is essential to balance therapy discontinuation against risks of epilepsy recurrence. However, the risk factors predicting recurrence are yet to be identified. The present study was conducted in order to determine the rate of recurrence after gradual therapy discontinuation as well as its influential factors in epileptic patients under medical therapy who were seizure-free for a period of 2 years. Method and Materials: This is a descriptive cross-sectional study on epileptic patients who referred to the specialized neurology clinic of Kermanshah University of Medical Sciences from 1994 to 2010. The data were extracted from patients’ medical records and analyzed. Findings: A total of 391 patients were evaluated. In our study, 51.2% of patients experienced recurrence of seizure at the end of the 2-year follow-up. Recurrence occurred most frequently during medication tapering (51%). While the largest number of patients were aged under 12 years (178 patients; 45%), the rate of recurrence was greatest for patients aged 20–40 years (43 patients; 66.2%). Discussion and Conclusion: As our findings suggest, type of epilepsy, multidrug therapy, abnormal electroencephalography before discontinuation, and abnormal brain computed tomography scan are factors that influence the risk of recurrence after therapy discontinuation. It is essential for the physician to take these factors into account and weigh the risk of recurrence against the benefits of therapy discontinuation.

KEYWORDS: :

• epilepsy
• recurrence
• therapy discontinuation