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Study of Factors Responsible for Recurrence of Seizures in Controlled Epileptics for more than 1½ Years After Withdrawal of Antiepileptic Drugs
S.J. Lamdhade, G.M. Taori
Abstract
531 epileptic patients, who had achieved remission mostly for 2 years or more
were studied. The mean follow up period was 5 years. Recurrence was noted in
103 patients (19%) after gradual withdrawal of AED, over a period of 3-4 months.
424 patients (81%) did not have recurrence. The recurrence rate was influenced
adversely by factors like adolescent age and later onset seizures, pre-treatment
duration of symptoms more than 3 years, pretreatment precipitating factors
like emotional stress, lack of sleep and meals (however, number in each group
is small), positive family history of epilepsy, focal neurodeficit, absence
and myoclonic plus grandmal type of clinical seizures, paroxysmal generalized
spike and wave discharges and generalized short polyspike and wave discharges
in the pretreatment EEG, atrophic changes on CT brain scan (in small numbers),
head trauma at birth or later and hereditary factors as etiology of epilepsy,
and more than 30 number of seizures before achieving the remission. Factors
like, sex, frequency of seizures, period of remission i.e. two years or more
and number of drugs used to achieve remission, did not have any significant
adverse effect. However, in the last parameter 95% remission was achieved by
one or a combination of two drugs (72% and 23% respectively).
Keywords
Seizure, Recurrence, Factor, AED withdrawl
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