Discontinuing Antiepileptic Drugs after Pediatric Epilepsy Surgery for Focal Cortical Dysplasia.
10.26815/jkcns.2017.25.3.127
- Author:
Se Eun SEO
1
;
Se Hee KIM
;
Dong Suk KIM
;
Hoon Chul KANG
;
Joon Soo LEE
;
Heung Dong KIM
Author Information
1. Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea. SEHEEKIM@yuhs.ac
- Publication Type:Original Article
- Keywords:
Focal cortical dysplasia;
Epilepsy surgery;
Pediatric;
Antiepileptic drugs;
Withdraw;
Reduce
- MeSH:
Anticonvulsants*;
Classification;
Epilepsy*;
Follow-Up Studies;
Humans;
Malformations of Cortical Development*;
Recurrence;
Seizures
- From:
Journal of the Korean Child Neurology Society
2017;25(3):127-132
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Antiepileptic drugs (AEDs) can be discontinued in a subset of patients after surgery. We aimed to identify the factors related to successful AED withdrawal after surgery in pediatric patients with focal cortical dysplasia (FCD). METHODS: The study included 134 patients who underwent resective surgery for FCD at Severance Hospital between 2003 and 2014. Age of seizure onset, epilepsy duration, and location and histopathological classification of the FCD were compared between patients who experienced seizure recurrence and those who did not. The interval between surgery and initiation of AED reduction was also compared. RESULTS: In total, 134 patients were included. The median age at seizure onset was 1.0 year (interquartile range [IQR], 0.3–5.0). The median follow-up duration was 6.0 years (IQR, 1.0–13.0). AED withdrawal was attempted in 89 (66%), and 61 (69%) patients remained seizure-free. Of 61 patients, 38 (62%) were successfully weaned off all AEDs. Seizures recurred in 28 (31%) patients. The mean duration between surgery and initiation of AED reduction did not significantly differ between the seizure recurrence (4.5 months, IQR, 2.7–8.7) and non-recurrence groups (1.9 months, IQR, 0.5–5.4) (P<0.006). Patients who had FCD type IIb (39% vs. 7%, P=0.004) were more likely to be in the non-recurrence group than in the recurrence group (P=0.031). CONCLUSION: Surgical resection offers patients with FCD an opportunity to completely discontinue their AEDs. Early AED discontinuation may be pursued in patients with FCD in cases of complete resection.
