Evaluation of seizure recurrence rate and factors affecting seizure recurrence in pediatric epilepsy patients after discontinuation of antiepileptic treatment

Aim: The aim of this study is to retrospectively evaluate recurrence rates and risk factors affecting seizure recurrence after discontinuation of antiepileptic drugs in childhood epilepsy. Material and Methods: 262 patients whose antiepileptic drug treatment was discontinued after at least two years of seizure-free follow-up were evaluated. Patients whose seizures recurred after drug discontinuation were considered as the relapse group, and those whose seizures did not recur were considered as the remission group. After discontinuation of antiepileptic medication, patients were followed for at least 1 year. Factors that may cause relapse were examined. Results: Of the patients included in the study group, 25.5% were relapsed and 74.5% were in remission. Factors such as structural abnormality, seizure onset age under 5 years, cranial MRI abnormality, EEG abnormality at diagnosis, presence of neurological deficit, polytherapy, and seizure lasting longer than 10 minutes were found to be risk factors in univariate analyses. Cranial MRI abnormality, seizure lasting more than 10 minutes, and seizure onset age under 5 years were found to be risk factors for relapse in multivariate analyses. Discussion: In our study, the risk factors affecting relapse were found to be similar to the results of many previous studies. Seizure onset age under 5 years of age, cranial MRI abnormality, and seizures lasting longer than 10 minutes were found to be risk factors for relapse in multivariate analysis. Conclusion: Cranial MRI abnormality, seizure lasting more than 10 minutes, and seizure onset age under 5 years were found to be the most important risk factors for relapse.