Age at epilepsy diagnosis and EEG can help predict returning seizures after stopping epilepsy medicines, study finds

Adolescent age at diagnosis and unusual EEG findings are among the factors that predict breakthrough seizures after withdrawal of epilepsy medicines in children, according to a new Epilepsy & Behavior study.

The research, by Miraç Yıldırım and colleagues, investigated characteristics in children with epilepsy who had become seizure free with epilepsy medicines and who were able to come off their medicines. They wanted to find out if any characteristics could be used to predict whether the children would end up having returning seizures.

The research included 269 children who were seizure free and able to come off their epilepsy medicines. They were followed up for at least 18 months after epilepsy medicines were stopped.

The researchers found that around a third of the children (33.5%) ended up having breakthrough seizures. Of them, just under half (45.6%) had had their seizures return at six months, and around three quarters (74.4%) of them had had seizures at two years. Almost all (94.4%) of this group had returning seizures five years after stopping taking epilepsy medicines.

Among the characteristics studied, three of them predicted a higher chance of having returning seizures after coming off epilepsy medicines. These were adolescent age at diagnosis, unusual EEG findings after the epilepsy medicines were stopped, and having a high number of seizures while taking epilepsy medicines.

The researchers also identified some connected MRI findings, such as problems with the development of the outer layer of the brain or fluid build up in the brain. They found that they can be used as signals that there is a risk of returning seizures after stopping epilepsy medicines.

However, the researchers also found that the vast majority (93.3%) of the children who had returning seizures got seizure control again with just one epilepsy medicine.

The study is available online. 

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