Predictive Factors for the Relapse of Seizure after Withdrawal from the Monotherapy of the Antiepileptic Drug in Cryptogenic Partial Epilepsy

Kim, Chul Ho; Song, Hong Ki; Shin, Joon Hyun; Lee, Ju Hun; Kim, Woo Kyung; Kim, Yeung In; Shin, Dong Jin

Abstract

PURPOSE
There is no apparent consensus about the successful policy of antiepileptic drug (AED) withdrawal, nor about definite factors to make patients remain seizure-free. We attempted to find out the predictive factors for seizure relapse after withdrawal of AED in patients with cryptogenic partial epilepsy. METHODS: This is a case-controlled and hospital-based observational study. A total of 91 crytogenic partial epileptic patients in whom seizure had been successfully controlled by AED monotherapy for more than two years were subjected to drug withdrawal. Patients with history of febrile convulsion, status epilepticus, and abnormal intelligence were excluded. Subjects were divided into two groups; the first group consisted of patients with seizure free more than 2 years after withdrawal of AED and another group with seizure recurrence during tapering or after drug withdrawal. The group with successful withdrawal had 48 patients, and, in 43 patients, seizure was recurred. Clinical profiles were compared between the two groups. RESULTS: There was no significant difference in gender, family history, age at onset, number of seizure attacks before AED initiation, duration of illness before treatment, and seizure or epilepsy classifications between the two groups. However, an abnormal EEG finding was associated with seizure relapse (Chi-square test p<0.05). On the other hand, the number of seizure attacks and the interval between the AED initiation and the time when a seizure free period was achieved had a correlation with seizure relapse, but was not statistically significant. CONCLUSIONS: Abnormal EEG findings was the predictive factor for seizure relapse after withdrawal from AED monotherapy in cryptogenic partial epilepsy.