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Journal of Neurology

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01-10-2019 | Antiepileptic Drugs | Original Communication

Discontinuing antiepileptic drugs in long-standing idiopathic generalised epilepsy

Authors: Bernd J. Vorderwülbecke, Andrea Kirschbaum, Hannah Merkle, Philine Senf, Martin Holtkamp

Published in: Journal of Neurology | Issue 10/2019

Abstract

Background

Once adults with long-standing idiopathic generalised epilepsy have achieved stable seizure remission, patients or physicians may attempt to discontinue their antiepileptic drug treatment. To date, risk of subsequent seizure relapse across the four idiopathic generalised epilepsy syndromes is largely unknown, and so are the clinical variables associated.

Methods

For this retrospective observational study, 256 adult outpatients with idiopathic generalised epilepsy were evaluated. Data were obtained from outpatient charts and, if possible, from additional telephone or mail interviews.

Results

In 84 patients (33%), antiepileptic medication was discontinued at least once. Median patient age at antiepileptic drug withdrawal was 33 years, and median duration of subsequent follow-up was 20 years. Seizures recurred in 46% of patients after a median latency of 11 months. Following multivariable analysis, seizure relapse was independently associated with short duration of seizure remission beforehand. If medication was withdrawn after < 5 years of seizure freedom, two-thirds of patients had a seizure relapse, while among those in remission for ≥ 5 years, only one-third relapsed.

Conclusions

Discontinuation of antiepileptic drug treatment can be successful in every other adult with long-standing idiopathic generalised epilepsy. Short duration of prior seizure remission appears to be a relevant predictor of seizure recurrence.

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Title: Discontinuing antiepileptic drugs in long-standing idiopathic generalised epilepsy
Authors: Bernd J. Vorderwülbecke
Andrea Kirschbaum
Hannah Merkle
Philine Senf
Martin Holtkamp
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Keywords: Antiepileptic Drugs
Juvenile Myoclonic Epilepsy
Epilepsy
Antiepileptic Drugs
Absence Seizure
Published in: Journal of Neurology / Issue 10/2019
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-019-09457-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Discontinuing antiepileptic drugs in long-standing idiopathic generalised epilepsy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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