Work

Retirada y reintroducción del tratamiento farmacológico de la epilepsia en pacientes pediátricos. Nuestra experiencia

Year: 2024

Type: article

Abstract: INTRODUCTION: There are many variables to be considered in the withdrawal of treatment for epileptic seizures, which requires a risk-benefit assessment. PATIENTS AND METHODS: A retrospective study of patients in a neuropaediatric practice who required the reintroduction of treatment for epilepsy after its initial withdrawal, and who continue to receive anti-seizure drugs. RESULTS: Twenty-three of 57 children whose treatment was withdrawn are currently being administered the treatment as a monotherapy. Attempts at withdrawal were made with 17 patients, with a mean seizure-free period of 26 months; range: 8-47 months (excluding one patient who never stopped presenting seizures). Mean age at the time of the last known data: 16 years; range: 7-28 years. Average time until the first seizure after withdrawal: 12 months; range: 1-82 months. Seizures persist despite the current treatment administered in eight cases. Two or three attempts to withdraw treatment were made in six patients, with a mean seizure-free period of 28.6 months; range: 22-48 months. Mean age at the time of the last known data: 18.68 years; range: 13-37 years. Average time until the first seizure after withdrawal: 8.2 months; range: 1-30 months. They presented seizures after treatment four was reintroduced. 52% of the patients presented seizures while receiving the drug, which was discontinued. The treatment was withdrawn in cases meeting criteria for persistent seizures: three refractory epilepsies, five symptomatic focal epilepsies, four cases with intellectual disability, five adolescent-onset epilepsies, and failures in previous withdrawal in 23 cases and 30 attempts. CONCLUSION: The decision to withdraw treatment must be personalised, and consider the risk of relapse, taking into account efficacy and tolerability, and behaviour and neurodevelopment in particular.

Source: Revista de Neurología

DOI: 10.33588/rn.7906.2024268

Authors: Patricia Morte Coscolín, Candela Gómez Sánchez, Javier López Pisón, Maria Violeta Fariña Jara, Fernando Francisco Martínez Calvo, Ruth Fernando Martínez

Institutions: Hospital Universitario Miguel Servet, IDCQ Hospitales y Sanidad, S.L.U.

Language: Spanish

Topic: Epilepsy research and treatment

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

OpenAlex ID: W4402555010