Patients who were seizure free for the first 5 years after resecti
ve epilepsy surgery were included. Date of first seizure recurrence, current seizure status, medication, age, and type of surgery were prospecti
vely registered. Non-parametric statistics were used.
Results
One hundred and fifty-nine patients were studied. Thirty-two had at least one recurrent seizure. Time to event analysis showed an annual relapse rate of 4 % between years 5 and 10 after surgery. At study termination, 143 of 159 patients (89.9 % ) were in terminal remission. For 30 patients with late relapse and at least 1-year follow-up thereafter, 53 % were in terminal remission and 30 % had experienced only rare or nocturnal seizures. Medication use was not associated either with likelihood of relapse or entering remission after relapse.
Conclusions
Patients who are seizure free for the first 5 years after epilepsy surgery remain at risk for seizure recurrence. These relapses are often isolated events, and the long-term prognosis after relapse is often good. Relapse rates were similar in patients on and off AEDs, but the relation between AED taper and relapse is uncertain since patient groups may not be similar.v>v>
verDate=01 % 2F31 % 2F2008&_sk=999219998&view=c&wchp=dGLzVzz-zSkzk&md5=3cad05de29ac39be90fde787329fc214&ie=/sdarticle.pdf"">![]()
vertical-align:absmiddle;"" border=""0"" src=""http://www.sciencedirect.com/scidirimg/icon_pdf.gif"" alt=""""> Purchase PDF (183 K)v>v>v class=""infobubble-container"">v class=""mlktLink"" id=""mlktLink_2"">v class=""infobubble"" id=""infobubble_2"" onMouseOver=""InfoBubble.show('infobubble_2','mlktLink_2')"" onMouseOut=""InfoBubble.timeout()"">v style=""float:right; padding-left:5px"">![]() ver=""javascript:this.src='/scidirimg/btn_xclose_hov.gif';"" onmouseout=""javascript:this.src='/scidirimg/btn_xclose.gif';"">v>![]() verDate=03 % 2F31 % 2F2007&_rdoc=1&_fmt=high&_orig=article&_cdi=7141&_sort=v&_docanchor=&view=c&_ct=1089&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=f5af7bbcb40ed85abff61d2cc3aa4a20"">Seizure freedom off antiepileptic drugs after temporal lobe epilepsy surgery
Seizure, Volume 16, Issue 2, March 2007, Pages 95-98
Muhammad Al-Kaylani, Peter Konrad, Barry Lazenby, Bennett Blumenkopf, Bassel Abou-Khalil
Abstract
v class=""mlktScroll"">v style=""line-height:150 % "">SummaryData are limited on seizure recurrence after antiepileptic drug (AED) discontinuation in operated seizure-free patients. We reviewed seizure outcome in patients who came off AEDs after being seizure-free for 2 years following temporal lobe surgery in our center. Thirty-nine (68 % ) of 57 patients who discontinued AED therapy remained seizure-free. They had a younger age at surgery than the group with seizure recurrence (p = 0.01). Earlier surgery may be a favorable predictor for seizure freedom after AED discontinuation.v>v>
verDate=03 % 2F31 % 2F2007&_sk=999839997&view=c&wchp=dGLzVzz-zSkzk&md5=39106192fd7e48f984feaa4c7044e471&ie=/sdarticle.pdf"" target=""newPdfWin"" onClick=""var newWidth=((document.body.clientWidth*90)/100); var newHeight=document.body.clientHeight; var pdfWin; pdfWin=window.open('','newPdfWin','width='+newWidth+',height='+newHeight+',resizable=yes, left=50, top=50');pdfWin.focus()"">![]() vertical-align:absmiddle;"" border=""0"" src=""http://www.sciencedirect.com/scidirimg/icon_pdf.gif"" alt=""""> PDF (82 K) |
v>v>v class=""infobubble-container"">v class=""mlktLink"" id=""mlktLink_3"">v class=""infobubble"" id=""infobubble_3"" onMouseOver=""InfoBubble.show('infobubble_3','mlktLink_3')"" onMouseOut=""InfoBubble.timeout()"">v style=""float:right; padding-left:5px"">![]() ver=""javascript:this.src='/scidirimg/btn_xclose_hov.gif';"" onmouseout=""javascript:this.src='/scidirimg/btn_xclose.gif';"">v>![]() verDate=01 % 2F31 % 2F2008&_rdoc=1&_fmt=high&_orig=article&_cdi=7141&_sort=v&_docanchor=&view=c&_ct=1089&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=7d4ad34be4dd6809cd8890f1da68a17d"">Factors related to successful antiepileptic drug withdrawal after anterior temporal lobectomy for medial temporal lobe epilepsy
Seizure, Volume 17, Issue 1, January 2008, Pages 11-18
Seo-Young Lee, Ji-Young Lee, Dong Wook Kim, Sang Kun Lee, Chun Kee Chung
Abstract
v class=""mlktScroll"">v style=""line-height:150 % "">SummaryObjectiveTo assess the rate of successful antiepileptic drug (AED) discontinuation, prognostic factors and proper time of AED withdrawal after surgery for medial temporal lobe epilepsy (MTLE).MethodsWe reviewed 171 consecutive patients who underwent resective surgery for MTLE. All patients were followed up for more than two postoperative years. AEDs were slowly tapered with an individualized schedule for each patient. Outcome status was determined from medical records and telephone interviews. Results41.2 % of patients experienced no seizure recurrence. 34.5 % discontinued medication without seizure recurrence for more than 2 years at final assessment. Multivariate analysis revealed that an age greater than 30 years at surgery and postoperative AED reduction before 10 months increased the risk of recurrence [hazard ratio (HR) 2.1, 95 % confidence interval (CI) 1.1–3.9 and HR 2.5, CI 1.1–5.8]. ConclusionsResective surgery for MTLE brings seizure remission without AED to one-third of patients. Postoperative AED tapering is recommended after at least 10 months. Younger age at surgery is a good predictive factor of remission after MTLE surgery. v>v>
verDate=01 % 2F31 % 2F2008&_sk=999829998&view=c&wchp=dGLzVzz-zSkzk&md5=b5905a4ae9241b1a7dc834160ef51e23&ie=/sdarticle.pdf"">![]() vertical-align:absmiddle;"" border=""0"" src=""http://www.sciencedirect.com/scidirimg/icon_pdf.gif"" alt=""""> Purchase PDF (272 K) |
v>v> |
| v> |
![]() ver=""mlktHover(1,'/scidirimg/sci_dir/')"" onmouseout=""mlktHover(0,'/scidirimg/')""> |
| |
| valign=""middle"">md5 % 3D919fb0f1cb4c1c0c70ef7533a5f3cd43&_acct=C000050221&_version=1&_userid=10&md5=01ddaddea104d9e8a80c07afbe66eb6b"" target=""outwardLink"" onClick=""var outwardWin; outwardWin=window.open('','outwardLink','scrollbars=yes,resizable=yes,directories=yes,toolbar=yes,menubar=yes,status=yes,location=yes,width=610,height=480,screenX=10,screenY=10'); outwardWin.focus()"">View Record in Scopus |
|
| |
| v id=""CollabBoxContent"">v> |
v id=""articleBody"" class=""font3"">v class=""articleHeaderInner"" id=""articleHeader"">![]()
var doiWin; doiWin=window.open('http://dx.doi.org/10.1016/j.pediatrneurol.2008.01.010','doilink','scrollbars=yes,resizable=yes,directories=yes,toolbar=yes,menubar=yes,status=yes'); doiWin.focus()"">doi:10.1016/j.pediatrneurol.2008.01.010 version=1&_urlVersion=0&_userid=10&md5=a143a86ddc585c54adbe80b2046626c3"" target=""sdhelp"" onMouseOver = ""window.status='Help is Available';return true"" onClick=""var helpWin; helpWin=window.open('/science?_ob=HelpURL&_file=doi.htm&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=a143a86ddc585c54adbe80b2046626c3','sdhelp','scrollbars=yes,resizable=yes,directories=no,toolbar=no,menubar=no,status=no,width=760,height=570'); helpWin.focus()"">![]()
Copyright © 2008 Elsevier Inc. All rights reserved. Original article
v class=""articleTitle"">Discontinuation of Medications After Successful Epilepsy Surgery in Children
