What are the predominant predictors of seizure relapse following discontinuation of anti-seizure medication in epileptic children?

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dc.authoridSERIN, Hepsen Mine/0000-0002-6296-1048
dc.authoridToprak, Dilara Ece/0000-0002-3833-1230
dc.authorid, sanem/0000-0002-8719-0665
dc.authoridSimsek, Erdem/0000-0002-4413-8779
dc.authoridKanmaz, Seda/0000-0002-8738-1242
dc.authorscopusid57205023509
dc.authorscopusid58139850600
dc.authorscopusid57729247600
dc.authorscopusid55638300200
dc.authorscopusid57189047650
dc.authorscopusid55331029300
dc.authorscopusid36571118200
dc.authorwosidSimsek, Erdem/A-9776-2018
dc.contributor.authorKanmaz, Seda
dc.contributor.authorToprak, Dilara Ece
dc.contributor.authorOlculu, Cemile Busra
dc.contributor.authorDokurel, Ipek
dc.contributor.authorSimsek, Erdem
dc.contributor.authorSerin, Hepsen Mine
dc.contributor.authorYilmaz, Sanem
dc.date.accessioned2024-08-25T18:39:04Z
dc.date.available2024-08-25T18:39:04Z
dc.date.issued2023
dc.departmentEge Üniversitesien_US
dc.description.abstractObjective: The aim of the study was to identify the predominant predictors of seizure relapse following discontinuation of ASM in epileptic children. Methods: The study cohort consisted of 403 epileptic children who had a with-drawal process of ASM (monotherapy: 344; dual therapy or polytherapy: 59) after at least a 2- year seizure- free period. Patients were categorized if they had a well-defined epileptic syndrome. Epileptic children with ongoing ketogenic diet, vagal nerve stimulation, or surgery were excluded from the cohort due to the additional withdrawal process related to other therapy modalities. Results: The cohort's seizure relapse rate was 12.7% (51/403). The highest rates of seizure relapse were defined for genetic etiology at 25% and structural etiology at 14.9%. An epilepsy syndrome was defined in 183 of 403 children (45.4%). There was no difference in the seizure relapse rate between the subgroups of well-defined epileptic syndromes; 13.8% for self-limited focal epileptic syndromes, 11.7% for developmental and epileptic encephalopathies, and 7.1% for generalized epileptic syndromes. Five predictors were defined as the most powerful predictors of seizure relapse in univariate analysis: age at epilepsy diagnosis >2 years (hazard ratio [HR]: 1.480; 95% confidence interval [CI]: 1.134- 1.933), defined etiology (HR: 1.304; 95% CI: 1.003- 1.696), focal seizure (HR: 1.499; 95% CI: 1.209- 1.859), =3 months duration of the withdrawal process (HR: 1.654; 95% CI: 1.322- 2.070), and a history of neona-tal encephalopathy with or without seizures (HR: 3.140; 95% CI: 2.393- 4.122). In multivariate analysis, the main predictor of seizure relapse was a history of neonatal encephalopathy with or without seizures (HR: 2.823; 95% CI: 2.067- 3.854). Significance: The duration of seizure freedom before discontinuation of ASM was not a predominant risk factor for seizure relapse: 2- 3 years versus >3 years. The predictive values of five predictors of seizure relapse rate should be evaluated for patients with different epilepsy subgroups.en_US
dc.identifier.doi10.1002/epd2.20019
dc.identifier.endpage228en_US
dc.identifier.issn1294-9361
dc.identifier.issn1950-6945
dc.identifier.issue2en_US
dc.identifier.pmid37358927en_US
dc.identifier.scopus2-s2.0-85158154857en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage218en_US
dc.identifier.urihttps://doi.org/10.1002/epd2.20019
dc.identifier.urihttps://hdl.handle.net/11454/101214
dc.identifier.volume25en_US
dc.identifier.wosWOS:000983169700001en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.ispartofEpileptic Disordersen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmz20240825_Gen_US
dc.subjectanti-seizure medicationen_US
dc.subjectASM withdrawalen_US
dc.subjectchildhooden_US
dc.subjectepilepsyen_US
dc.subjectpredictoren_US
dc.subjectAntiepileptic Drugsen_US
dc.subjectChildhood Epilepsyen_US
dc.subjectWithdrawalen_US
dc.subjectRisken_US
dc.subjectRecurrenceen_US
dc.subjectTherapyen_US
dc.titleWhat are the predominant predictors of seizure relapse following discontinuation of anti-seizure medication in epileptic children?en_US
dc.typeArticleen_US

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