Yuchen Gao, Xuan Li, Zenghua Yong, Baoqiang Yuan, Yunlong Dou
{"title":"135例癫痫患儿停药后复发危险因素分析。","authors":"Yuchen Gao, Xuan Li, Zenghua Yong, Baoqiang Yuan, Yunlong Dou","doi":"10.1016/j.eplepsyres.2025.107638","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To identify risk factors for seizure recurrence following anti-seizure medication (ASM) withdrawal in children with epilepsy who achieved sustained seizure freedom.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 135 children with epilepsy from a single tertiary center (2022--2023) meeting withdrawal criteria (aged <16 years, seizure-free ≥2 years on stable ASMs, followed ≥1 year after withdrawal). Participants were grouped by postwithdrawal seizure relapse status: recurrent (n = 42) and nonrecurrent (n = 93). Thirteen risk factors were compared via chi-square tests. Variables significantly associated (P < 0.05) with recurrence in univariate analysis were entered into multivariate logistic regression to identify independent predictors (reported as ORs with 95 % CIs). The analyses were performed with SPSS 19.0.</p><p><strong>Results: </strong>The overall recurrence rate was 31.11 % (42/135), with 80.95 % of recurrences occurring during ASM tapering or within the first year after withdrawal. Univariate analysis revealed significant differences between the recurrence and nonrecurrence groups regarding prewithdrawal EEG abnormalities (P = 0.006), ASM polytherapy (P = 0.003), time to seizure freedom > 1 year (P = 0.037), pretreatment epilepsy duration > 1 year (P = 0.011), presence of comorbidities (P < 0.001), and multiple seizure types (P = 0.020). Multivariate logistic regression confirmed three independent risk factors for recurrence: (1) abnormal EEG before withdrawal (OR=9.268, 95 % CI: 2.255-38.092, P = 0.002), (2) ASM polytherapy (OR=3.205, 95 % CI: 1.159-8.866, P = 0.025), and (3) pretreatment epilepsy duration > 1 year (OR=5.363, 95 % CI: 1.781-16.150, P = 0.003).</p><p><strong>Conclusion: </strong>Abnormal EEG before withdrawal, polytherapy, and pretreatment duration > 1 year predicted recurrence. Enzyme-induction patterns showed exploratory associations requiring further validation.</p>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"107638"},"PeriodicalIF":2.0000,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Analysis of risk factors for recurrence after the withdrawal of ASMs in 135 children with epilepsy.\",\"authors\":\"Yuchen Gao, Xuan Li, Zenghua Yong, Baoqiang Yuan, Yunlong Dou\",\"doi\":\"10.1016/j.eplepsyres.2025.107638\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To identify risk factors for seizure recurrence following anti-seizure medication (ASM) withdrawal in children with epilepsy who achieved sustained seizure freedom.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 135 children with epilepsy from a single tertiary center (2022--2023) meeting withdrawal criteria (aged <16 years, seizure-free ≥2 years on stable ASMs, followed ≥1 year after withdrawal). Participants were grouped by postwithdrawal seizure relapse status: recurrent (n = 42) and nonrecurrent (n = 93). Thirteen risk factors were compared via chi-square tests. Variables significantly associated (P < 0.05) with recurrence in univariate analysis were entered into multivariate logistic regression to identify independent predictors (reported as ORs with 95 % CIs). The analyses were performed with SPSS 19.0.</p><p><strong>Results: </strong>The overall recurrence rate was 31.11 % (42/135), with 80.95 % of recurrences occurring during ASM tapering or within the first year after withdrawal. Univariate analysis revealed significant differences between the recurrence and nonrecurrence groups regarding prewithdrawal EEG abnormalities (P = 0.006), ASM polytherapy (P = 0.003), time to seizure freedom > 1 year (P = 0.037), pretreatment epilepsy duration > 1 year (P = 0.011), presence of comorbidities (P < 0.001), and multiple seizure types (P = 0.020). Multivariate logistic regression confirmed three independent risk factors for recurrence: (1) abnormal EEG before withdrawal (OR=9.268, 95 % CI: 2.255-38.092, P = 0.002), (2) ASM polytherapy (OR=3.205, 95 % CI: 1.159-8.866, P = 0.025), and (3) pretreatment epilepsy duration > 1 year (OR=5.363, 95 % CI: 1.781-16.150, P = 0.003).</p><p><strong>Conclusion: </strong>Abnormal EEG before withdrawal, polytherapy, and pretreatment duration > 1 year predicted recurrence. Enzyme-induction patterns showed exploratory associations requiring further validation.</p>\",\"PeriodicalId\":11914,\"journal\":{\"name\":\"Epilepsy Research\",\"volume\":\"218 \",\"pages\":\"107638\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-08-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Epilepsy Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.eplepsyres.2025.107638\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Epilepsy Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.eplepsyres.2025.107638","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Analysis of risk factors for recurrence after the withdrawal of ASMs in 135 children with epilepsy.
Objective: To identify risk factors for seizure recurrence following anti-seizure medication (ASM) withdrawal in children with epilepsy who achieved sustained seizure freedom.
Methods: This retrospective cohort study analyzed 135 children with epilepsy from a single tertiary center (2022--2023) meeting withdrawal criteria (aged <16 years, seizure-free ≥2 years on stable ASMs, followed ≥1 year after withdrawal). Participants were grouped by postwithdrawal seizure relapse status: recurrent (n = 42) and nonrecurrent (n = 93). Thirteen risk factors were compared via chi-square tests. Variables significantly associated (P < 0.05) with recurrence in univariate analysis were entered into multivariate logistic regression to identify independent predictors (reported as ORs with 95 % CIs). The analyses were performed with SPSS 19.0.
Results: The overall recurrence rate was 31.11 % (42/135), with 80.95 % of recurrences occurring during ASM tapering or within the first year after withdrawal. Univariate analysis revealed significant differences between the recurrence and nonrecurrence groups regarding prewithdrawal EEG abnormalities (P = 0.006), ASM polytherapy (P = 0.003), time to seizure freedom > 1 year (P = 0.037), pretreatment epilepsy duration > 1 year (P = 0.011), presence of comorbidities (P < 0.001), and multiple seizure types (P = 0.020). Multivariate logistic regression confirmed three independent risk factors for recurrence: (1) abnormal EEG before withdrawal (OR=9.268, 95 % CI: 2.255-38.092, P = 0.002), (2) ASM polytherapy (OR=3.205, 95 % CI: 1.159-8.866, P = 0.025), and (3) pretreatment epilepsy duration > 1 year (OR=5.363, 95 % CI: 1.781-16.150, P = 0.003).
Conclusion: Abnormal EEG before withdrawal, polytherapy, and pretreatment duration > 1 year predicted recurrence. Enzyme-induction patterns showed exploratory associations requiring further validation.
期刊介绍：
Epilepsy Research provides for publication of high quality articles in both basic and clinical epilepsy research, with a special emphasis on translational research that ultimately relates to epilepsy as a human condition. The journal is intended to provide a forum for reporting the best and most rigorous epilepsy research from all disciplines ranging from biophysics and molecular biology to epidemiological and psychosocial research. As such the journal will publish original papers relevant to epilepsy from any scientific discipline and also studies of a multidisciplinary nature. Clinical and experimental research papers adopting fresh conceptual approaches to the study of epilepsy and its treatment are encouraged. The overriding criteria for publication are novelty, significant clinical or experimental relevance, and interest to a multidisciplinary audience in the broad arena of epilepsy. Review articles focused on any topic of epilepsy research will also be considered, but only if they present an exceptionally clear synthesis of current knowledge and future directions of a research area, based on a critical assessment of the available data or on hypotheses that are likely to stimulate more critical thinking and further advances in an area of epilepsy research.
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