Department of Neurology, First Affiliated Hospital of Kunming Medical University, 295 Xi Chang Road, Kunming, Yunnan 650032, PR China.
Department of Neurology, First Affiliated Hospital of Kunming Medical University, 295 Xi Chang Road, Kunming, Yunnan 650032, PR China.
Epilepsy Behav. 2020 Sep;110:107156. doi: 10.1016/j.yebeh.2020.107156. Epub 2020 Jun 7.
Many seizure-free patients who consider withdrawing from antiepileptic drugs (AEDs) hope to discontinue treatment to avoid adverse effects. However, withdrawal has certain risks that are difficult to predict. In this study, we performed a literature review, summarized the causes of significant variability in the risk of postwithdrawal recurrent seizures, and reviewed study data on the age at onset, cause, types of seizures, epilepsy syndrome, magnetic resonance imaging (MRI) abnormalities, epilepsy surgery, and withdrawal outcomes of patients with epilepsy. Many factors are associated with recurrent seizures after AED withdrawal. For patients who are seizure-free after treatment, the role of an electroencephalogram (EEG) alone in ensuring safe withdrawal is limited. A series of prediction models for the postwithdrawal recurrence risk have incorporated various potentially important factors in a comprehensive analysis. We focused on the populations of studies investigating five risk prediction models and analyzed the predictive variables and recommended applications of each model, aiming to provide a reference for personalized withdrawal for patients with epilepsy in clinical practice.
许多无癫痫发作的患者在考虑停用抗癫痫药物 (AED) 时，希望停止治疗以避免不良反应。然而，停药存在一定的风险，难以预测。本研究进行了文献回顾，总结了导致停药后复发癫痫风险显著变化的原因，并回顾了关于癫痫患者发病年龄、病因、发作类型、癫痫综合征、磁共振成像 (MRI) 异常、癫痫手术和停药结局的数据。许多因素与 AED 停药后复发癫痫有关。对于治疗后无癫痫发作的患者，单独使用脑电图 (EEG) 来确保安全停药的作用有限。一系列用于预测停药后复发风险的预测模型综合分析了各种潜在的重要因素。我们关注了研究五个风险预测模型的人群，并分析了每个模型的预测变量和推荐应用，旨在为临床实践中癫痫患者的个体化停药提供参考。
