Relapse after treatment withdrawal of antiepileptic drugs for Juvenile Absence Epilepsy and Juvenile Myoclonic Epilepsy
Autor: | Rania Alzoubidi, M. O'Donoghue, Liam Healy, William P Whitehouse, María Morán, Sumeet Singhal |
---|---|
Rok vydání: | 2018 |
Předmět: |
Adult
Male 0301 basic medicine Pediatrics medicine.medical_specialty Adolescent Antiepileptic drug 030105 genetics & heredity Teaching hospital Juvenile Absence Epilepsy Young Adult 03 medical and health sciences Epilepsy 0302 clinical medicine Recurrence Seizures medicine Humans Seizure activity Aged Retrospective Studies Aged 80 and over business.industry Myoclonic Epilepsy Juvenile Remission Induction General Medicine Middle Aged medicine.disease Treatment Outcome Epilepsy Absence Neurology Myoclonic epilepsy Anticonvulsants Female Neurology (clinical) Juvenile myoclonic epilepsy business 030217 neurology & neurosurgery After treatment |
Zdroj: | Seizure. 59:116-122 |
ISSN: | 1059-1311 |
Popis: | Purpose Conventional teaching is that juvenile myoclonic epilepsy (JME) and juvenile absence epilepsy (JAE) require lifelong antiepileptic drug (AED) treatment. We therefore wanted to determine how many patients attending our epilepsy service with JAE or JME went into 2 year remission, and then relapsed, both off and on AEDs. Method This was a retrospective case-notes review. Patients with JAE and JME were systematically ascertained from clinic lists and databases at one teaching hospital. Data was extracted systematically. Simple descriptive statistics were used. Results JAE: 14/36 (39%) were seizure free on AEDs for at least 2 years. Of the 6 (43%) attempting AED withdrawal, all (100%) relapsed, compared with only 25% of those who did not withdraw AEDs. Only 2/5 who relapsed and restarted AEDs regained remission. JME: 32/145 (22%) were seizure free on AEDs for at least 2 years. Of the 10 (31%) attempting AED withdrawal, 8 (80%) relapsed, compared with only 36% of those who did not withdraw AEDs. Only 2/8 who relapsed and restarted AEDs regained remission. Conclusion Remission rates for JAE and JME was lower than expected. Higher proportions of seizure free patients underwent physician-supervised withdrawal than anticipated. Relapse rates off AEDs were similar for JAE and JME, and at least twice as high as for those remaining on AEDs, and a further remission was not invariable on restarting AEDs. Our experience, comparing relapse in those withdrawing to those staying on AEDs will help in discussions with patients keen to try AED withdrawal. |
Databáze: | OpenAIRE |
Externí odkaz: |