癫痫患儿停药后复发影响因素的研究进展_Journal of Epilepsy

Authors：

肖彦丽 ¹ , 雍曾花 ² , 窦云龙 ² ,  袁宝强 ²

1. ;
2. ;

Corresponding author：

袁宝强, Email: 475154304@qq.com

Keywords：

儿童癫痫; 停药; 复发; 影响因素

DOI：

10.7507/2096-0247.20200025

Video：

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癫痫是一种脑部疾患，其特点是持续存在能导致癫痫发作的脑电改变，并出现相应的神经生物学、认知、心理学以及社会等方面的后果。经合理治疗后，大多数患儿的发作是可以控制的。癫痫缓解后可以考虑减停药物，但在减停药物的患儿中仍有 12%～67% 的复发风险。国内外就影响癫痫患儿复发的因素尚未达成共识。文章从可能影响癫痫患儿复发的因素方面进行综述，以期对儿童神经科医生指导患儿减停药物有所帮助，从而将复发率降至最低。

Citation： 肖彦丽, 雍曾花, 窦云龙, 袁宝强. 癫痫患儿停药后复发影响因素的研究进展. Journal of Epilepsy, 2020, 6(2): 141-144. doi: 10.7507/2096-0247.20200025 Copy

1.	Fiest KM, Sauro KM, Wiebe S, et al. Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies. Neurology, 2017, 88(3): 296-303.
2.	Moosa ANV. Antiepileptic drug treatment of epilepsy in children. CONTINUUM Lifelong Learning in Neurology, 2019, 25(2): 381-407.
3.	Sankaraneni, Ram, Lachhwani, Deepak. Antiepileptic drugs-a review. Pediatric Annals, 2015, 44(2): e36-e42.
4.	Rathore C, Paterson R. Stopping antiepileptic drugs in patients with epilepsy in remission: why, when and how? Neurology India, 2014, 62(1): 3-8.
5.	Braun K PJ, Schmidt D. Stopping antiepileptic drugs in seizure-free patients. Current Opinion in Neurology, 2014, 27(2): 219-226.
6.	Shih JJ, Ochoa JG. A Systematic Review of antiepileptic drug initiation and withdrawal. The Neurologist, 2009, 15(3): 122-131.
7.	Karalok ZS, Guven A, Öztürk Z, et al. Risk factors for recurrence after drug withdrawal in childhood epilepsy. Brain Dev, 2020, 42(1): 35-40.
8.	Loscher W, Brandt C. High seizure frequency prior to antiepileptic treatment is a predictor of pharmacoresistant epilepsy in a rat model of temporal lobe epilepsy. Epilepsia, 2010, 51(1): 89-97.
9.	Cardoso T AMO, Cendes F, Guerreiro C AM. Is low antiepileptic drug dose effective in long-term seizure-free patients? Arq Neuropsiquiatr, 2003, 61(3A): 566-573.
10.	Falco-Walter JJ, Scheffer IE, Fisher RS. The new definition and classification of seizures and epilepsy. Epilepsy Research, 2018, 139: 73-79.
11.	Hawash KY, Rosman NP. Do partial seizures predict an increased risk of seizure recurrence after antiepilepsy drugs are withdrawn? Journal of Child Neurology, 2003, 18(5): 331-337.
12.	Daoud AS, Ajloni S, El-Salem K, et al. Risk of seizure recurrence after a first unprovoked seizure: a prospective study among Jordanian children. Seizure, 2004, 13(2): 99-103.
13.	Vorderwvlbecke BJ, Kowski AB, Kirschbaum A, et al. Long-term outcome in adolescent-onset generalized genetic epilepsies. Epilepsia, 2017, 58(7): 1244-1250.
14.	Callaghan B, Schlesinger M, Rodemer W, et al. Remission and relapse in a drug-resistant epilepsy population followed prospectively. Epilepsia, 2011, 52(3): 619-626.
15.	Dragoumi P, Tzetzi O, Vargiami E, et al. Clinical course and seizure outcome of idiopathic childhood epilepsy: determinants of early and long-term prognosis. BMC Neurology, 2013, 17(1): 206.
16.	Li W, Si Y, Zou X M, et al. Prospective study on the withdrawal and reinstitution of antiepileptic drugs among seizure-free patients in west China. Journal of Clinical Neuroscience, 2014, 21(6): 997-1001.
17.	Rizvi Syed, Ladino Lady Diana, Hernandez-Ronquillo Lizbeth, et al. Epidemiology of early stages of epilepsy: risk of seizure recurrence after a first seizure. Seizure, 2017, 49: 46-53.
18.	Tang L, Xiao Z. Can electroencephalograms provide guidance for the withdrawal of antiepileptic drugs: A meta-analysis. Clinical Neurophysiology, 2017, 128(2): 297-302.
19.	Maia C, Moreira AR, Lopes T, et al. Risk of recurrence after a first unprovoked seizure in children. Jornal de Pediatria, 2017, 93(3): 281-286.
20.	Chen T, Si Y, Chen D, et al. The value of 24-hour video-EEG in evaluating recurrence risk following a first unprovoked seizure: a prospective study. Seizure, 2016, 40: 46-51.
21.	Yao J, Wang H, Xiao Z. Correlation between EEG during AED withdrawal and epilepsy recurrence: a meta-analysis. Neurological Sciences, 2019, 40(8): 1637-1644.
22.	Tang XH, Peimin Y, Ding D, et al. Risk factors for seizure reoccurrence after withdrawal from antiepileptic drugs in individuals who have been seizure-free for over 2 years. PLOS ONE, 2017, 12(8): e0181710.
23.	Caraballo R, Silva S, Beltran L, et al. Childhood-only epilepsy with generalized tonic-clonic seizures: A well-defined epileptic syndrome. Epilepsy Research, 2019, 153: 28-33.
24.	Stagi S, Lasorella S, Piccorossi A, et al. Cessation of epilepsy therapy in children. Expert Rev Neurother, 2016, 16(5): 549-559.
25.	Yamatani M, Konishi T, Matsuzawa J, et al. Relapse of seizure after withdrawal of antiepileptic drug treatment in childhood epilepsy: age-dependent factors. No to Hattatsu Brain & Development, 2000, 32(1): 15-20.
26.	Gherpelli JLD, Kok F, Forno SD, et al. Discontinuing medication in epileptic children: a study of risk factors related to recurrence. Epilepsia, 1992, 33(4): 681-686.
27.	Lamberink HJ, Otte WM, Geerts AT, et al. Individualised prediction model of seizure recurrence and long-term outcomes after withdrawal of antiepileptic drugs in seizure-free patients: a systematic review and individual participant data meta-analysis. Lancet Neurol, 2017, 16(7): 523-531.
28.	Kalita J, Vajpeyee A, Misra UK. Predictors of one-year seizure remission--a clinicoradiological and electroencephalographic study. Electromyogr Clin Neurophysiol, 2005, 45(3): 161-166.
29.	Ohta H, Ohtsuka Y, Tsuda T, et al. Prognosis after withdrawal of antiepileptic drugs in childhood-onset cryptogenic localization-related epilepsies. Brain & Development, 2004, 26(1): 19-25.
30.	Incecik F, Herguner OM, Altunbasak S, et al. Risk of recurrence after discontinuation of antiepileptic drug therapy in children with epilepsy. Journal of Pediatric Neurosciences, 2014, 9(2): 100-104.
31.	Olmez A, Arslan U, Turanli G, et al. Risk of recurrence after drug withdrawal in childhood epilepsy. Seizure, 2009, 18(4): 251-256.
32.	Bustos JA, Garcia HH, Del Brutto OH. Antiepileptic drug therapy and recommendations for withdrawal in patients with seizures and epilepsy due to neurocysticercosis. Expert Rev Neurother, 2016, 16(9): 1079-1085.
33.	Arthur TM, Degrauw TJ, Johnson CS, et al. Seizure recurrence risk following a first seizure in neurologically normal children. Epilepsia, 2008, 49(11): 1950-1954.
34.	Serra JG, Montenegro MA, Guerreiro MM. Antiepileptic drug withdrawal in childhood: does the duration of tapering off matter for seizure recurrence? Journal of Child Neurology, 2005, 20(7): 624-626.
35.	Ou S, Xia L, Li R, et al. Long-term outcome of seizure-free patients and risk factors of relapse following antiepileptic drug withdrawal. Epilepsy & Behavior, 2018, 88: 295-300.
36.	Park S, Lee DH, Kim SW, et al. Prognostic analysis of patients with epilepsy according to time of relapse after withdrawal of antiepileptic drugs following four seizure-free years. Epilepsia, 2017, 58(1): 60-67.
37.	Sartori S, Nosadini M, Tessarin G, et al. First-ever convulsive seizures in children presenting to the emergency department: risk factors for seizure recurrence and diagnosis of epilepsy. Developmental Medicine & Child Neurology, 2019, 61(1): 82-90.
38.	Lee IC, Li SY, Chen YJ. Seizure recurrence in children after stopping antiepileptic medication: 5-year follow-up. Pediatrics & Neonatology, 2017, 58(4): 338-343.
39.	Specchio LM, Beghi E. Should antiepileptic drugs be withdrawn in seizure-free patients? CNS Drugs, 2004, 18(4): 201-212.
40.	Stevelink R, Koeleman BPC, Sander JW, et al. Refractory juvenile myoclonic epilepsy: a meta‐analysis of prevalence and risk factors. European Journal of Neurology, 2019, 26(6): 856-864.
41.	Fisher RS, Acevedo C, Areimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia, 2014, 55(4): 475-482.

1. Fiest KM, Sauro KM, Wiebe S, et al. Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies. Neurology, 2017, 88(3): 296-303.
2. Moosa ANV. Antiepileptic drug treatment of epilepsy in children. CONTINUUM Lifelong Learning in Neurology, 2019, 25(2): 381-407.
3. Sankaraneni, Ram, Lachhwani, Deepak. Antiepileptic drugs-a review. Pediatric Annals, 2015, 44(2): e36-e42.
4. Rathore C, Paterson R. Stopping antiepileptic drugs in patients with epilepsy in remission: why, when and how? Neurology India, 2014, 62(1): 3-8.
5. Braun K PJ, Schmidt D. Stopping antiepileptic drugs in seizure-free patients. Current Opinion in Neurology, 2014, 27(2): 219-226.
6. Shih JJ, Ochoa JG. A Systematic Review of antiepileptic drug initiation and withdrawal. The Neurologist, 2009, 15(3): 122-131.
7. Karalok ZS, Guven A, Öztürk Z, et al. Risk factors for recurrence after drug withdrawal in childhood epilepsy. Brain Dev, 2020, 42(1): 35-40.
8. Loscher W, Brandt C. High seizure frequency prior to antiepileptic treatment is a predictor of pharmacoresistant epilepsy in a rat model of temporal lobe epilepsy. Epilepsia, 2010, 51(1): 89-97.
9. Cardoso T AMO, Cendes F, Guerreiro C AM. Is low antiepileptic drug dose effective in long-term seizure-free patients? Arq Neuropsiquiatr, 2003, 61(3A): 566-573.
10. Falco-Walter JJ, Scheffer IE, Fisher RS. The new definition and classification of seizures and epilepsy. Epilepsy Research, 2018, 139: 73-79.
11. Hawash KY, Rosman NP. Do partial seizures predict an increased risk of seizure recurrence after antiepilepsy drugs are withdrawn? Journal of Child Neurology, 2003, 18(5): 331-337.
12. Daoud AS, Ajloni S, El-Salem K, et al. Risk of seizure recurrence after a first unprovoked seizure: a prospective study among Jordanian children. Seizure, 2004, 13(2): 99-103.
13. Vorderwvlbecke BJ, Kowski AB, Kirschbaum A, et al. Long-term outcome in adolescent-onset generalized genetic epilepsies. Epilepsia, 2017, 58(7): 1244-1250.
14. Callaghan B, Schlesinger M, Rodemer W, et al. Remission and relapse in a drug-resistant epilepsy population followed prospectively. Epilepsia, 2011, 52(3): 619-626.
15. Dragoumi P, Tzetzi O, Vargiami E, et al. Clinical course and seizure outcome of idiopathic childhood epilepsy: determinants of early and long-term prognosis. BMC Neurology, 2013, 17(1): 206.
16. Li W, Si Y, Zou X M, et al. Prospective study on the withdrawal and reinstitution of antiepileptic drugs among seizure-free patients in west China. Journal of Clinical Neuroscience, 2014, 21(6): 997-1001.
17. Rizvi Syed, Ladino Lady Diana, Hernandez-Ronquillo Lizbeth, et al. Epidemiology of early stages of epilepsy: risk of seizure recurrence after a first seizure. Seizure, 2017, 49: 46-53.
18. Tang L, Xiao Z. Can electroencephalograms provide guidance for the withdrawal of antiepileptic drugs: A meta-analysis. Clinical Neurophysiology, 2017, 128(2): 297-302.
19. Maia C, Moreira AR, Lopes T, et al. Risk of recurrence after a first unprovoked seizure in children. Jornal de Pediatria, 2017, 93(3): 281-286.
20. Chen T, Si Y, Chen D, et al. The value of 24-hour video-EEG in evaluating recurrence risk following a first unprovoked seizure: a prospective study. Seizure, 2016, 40: 46-51.
21. Yao J, Wang H, Xiao Z. Correlation between EEG during AED withdrawal and epilepsy recurrence: a meta-analysis. Neurological Sciences, 2019, 40(8): 1637-1644.
22. Tang XH, Peimin Y, Ding D, et al. Risk factors for seizure reoccurrence after withdrawal from antiepileptic drugs in individuals who have been seizure-free for over 2 years. PLOS ONE, 2017, 12(8): e0181710.
23. Caraballo R, Silva S, Beltran L, et al. Childhood-only epilepsy with generalized tonic-clonic seizures: A well-defined epileptic syndrome. Epilepsy Research, 2019, 153: 28-33.
24. Stagi S, Lasorella S, Piccorossi A, et al. Cessation of epilepsy therapy in children. Expert Rev Neurother, 2016, 16(5): 549-559.
25. Yamatani M, Konishi T, Matsuzawa J, et al. Relapse of seizure after withdrawal of antiepileptic drug treatment in childhood epilepsy: age-dependent factors. No to Hattatsu Brain & Development, 2000, 32(1): 15-20.
26. Gherpelli JLD, Kok F, Forno SD, et al. Discontinuing medication in epileptic children: a study of risk factors related to recurrence. Epilepsia, 1992, 33(4): 681-686.
27. Lamberink HJ, Otte WM, Geerts AT, et al. Individualised prediction model of seizure recurrence and long-term outcomes after withdrawal of antiepileptic drugs in seizure-free patients: a systematic review and individual participant data meta-analysis. Lancet Neurol, 2017, 16(7): 523-531.
28. Kalita J, Vajpeyee A, Misra UK. Predictors of one-year seizure remission--a clinicoradiological and electroencephalographic study. Electromyogr Clin Neurophysiol, 2005, 45(3): 161-166.
29. Ohta H, Ohtsuka Y, Tsuda T, et al. Prognosis after withdrawal of antiepileptic drugs in childhood-onset cryptogenic localization-related epilepsies. Brain & Development, 2004, 26(1): 19-25.
30. Incecik F, Herguner OM, Altunbasak S, et al. Risk of recurrence after discontinuation of antiepileptic drug therapy in children with epilepsy. Journal of Pediatric Neurosciences, 2014, 9(2): 100-104.
31. Olmez A, Arslan U, Turanli G, et al. Risk of recurrence after drug withdrawal in childhood epilepsy. Seizure, 2009, 18(4): 251-256.
32. Bustos JA, Garcia HH, Del Brutto OH. Antiepileptic drug therapy and recommendations for withdrawal in patients with seizures and epilepsy due to neurocysticercosis. Expert Rev Neurother, 2016, 16(9): 1079-1085.
33. Arthur TM, Degrauw TJ, Johnson CS, et al. Seizure recurrence risk following a first seizure in neurologically normal children. Epilepsia, 2008, 49(11): 1950-1954.
34. Serra JG, Montenegro MA, Guerreiro MM. Antiepileptic drug withdrawal in childhood: does the duration of tapering off matter for seizure recurrence? Journal of Child Neurology, 2005, 20(7): 624-626.
35. Ou S, Xia L, Li R, et al. Long-term outcome of seizure-free patients and risk factors of relapse following antiepileptic drug withdrawal. Epilepsy & Behavior, 2018, 88: 295-300.
36. Park S, Lee DH, Kim SW, et al. Prognostic analysis of patients with epilepsy according to time of relapse after withdrawal of antiepileptic drugs following four seizure-free years. Epilepsia, 2017, 58(1): 60-67.
37. Sartori S, Nosadini M, Tessarin G, et al. First-ever convulsive seizures in children presenting to the emergency department: risk factors for seizure recurrence and diagnosis of epilepsy. Developmental Medicine & Child Neurology, 2019, 61(1): 82-90.
38. Lee IC, Li SY, Chen YJ. Seizure recurrence in children after stopping antiepileptic medication: 5-year follow-up. Pediatrics & Neonatology, 2017, 58(4): 338-343.
39. Specchio LM, Beghi E. Should antiepileptic drugs be withdrawn in seizure-free patients? CNS Drugs, 2004, 18(4): 201-212.
40. Stevelink R, Koeleman BPC, Sander JW, et al. Refractory juvenile myoclonic epilepsy: a meta‐analysis of prevalence and risk factors. European Journal of Neurology, 2019, 26(6): 856-864.
41. Fisher RS, Acevedo C, Areimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia, 2014, 55(4): 475-482.

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Journal of Epilepsy

癫痫患儿停药后复发影响因素的研究进展

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