Relapse after treatment withdrawal of antiepileptic drugs for juvenile absence epilepsy and juvenile myoclonic epilepsy
Purpose Conventional teaching is that juvenile myoclonic epilepsy (JME) and juvenile absence epilepsy (JAE) require lifelong antiepileptic drug (AED) treatment. We therefore wanted to determine how many patients attending our epilepsy service with JAE or JME went into 2 year remission, and then rel...
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| Format: | Article |
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Elsevier
2018
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| Online Access: | https://eprints.nottingham.ac.uk/51980/ |
| _version_ | 1848798618542145536 |
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| author | Healy, Liam Moran, Maria Singhal, Sumeet O'Donoghue, Michael F Alzoubidi, Rania Whitehouse, William P. |
| author_facet | Healy, Liam Moran, Maria Singhal, Sumeet O'Donoghue, Michael F Alzoubidi, Rania Whitehouse, William P. |
| author_sort | Healy, Liam |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Purpose
Conventional teaching is that juvenile myoclonic epilepsy (JME) and juvenile absence epilepsy (JAE) require lifelong antiepileptic drug (AED) treatment. We therefore wanted to determine how many patients attending our epilepsy service with JAE or JME went into 2 year remission, and then relapsed, both off and on AEDs.
Method
This was a retrospective case-notes review. Patients with JAE and JME were systematically ascertained from clinic lists and databases at one teaching hospital. Data was extracted systematically. Simple descriptive statistics were used.
Results
JAE: 14/36 (39%) were seizure free on AEDs for at least 2 years. Of the 6 (43%) attempting AED withdrawal, all (100%) relapsed, compared with only 25% of those who did not withdraw AEDs. Only 2/5 who relapsed and restarted AEDs regained remission.
JME: 32/145 (22%) were seizure free on AEDs for at least 2 years. Of the 10 (31%) attempting AED withdrawal, 8 (80%) relapsed, compared with only 36% of those who did not withdraw AEDs. Only 2/8 who relapsed and restarted AEDs regained remission.
Conclusion
Remission rates for JAE and JME was lower than expected. Higher proportions of seizure free patients underwent physician-supervised withdrawal than anticipated. Relapse rates off AEDs were similar for JAE and JME, and at least twice as high as for those remaining on AEDs, and a further remission was not invariable on restarting AEDs. Our experience, comparing relapse in those withdrawing to those staying on AEDs will help in discussions with patients keen to try AED withdrawal. |
| first_indexed | 2025-11-14T20:22:38Z |
| format | Article |
| id | nottingham-51980 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:22:38Z |
| publishDate | 2018 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-519802020-05-04T19:50:41Z https://eprints.nottingham.ac.uk/51980/ Relapse after treatment withdrawal of antiepileptic drugs for juvenile absence epilepsy and juvenile myoclonic epilepsy Healy, Liam Moran, Maria Singhal, Sumeet O'Donoghue, Michael F Alzoubidi, Rania Whitehouse, William P. Purpose Conventional teaching is that juvenile myoclonic epilepsy (JME) and juvenile absence epilepsy (JAE) require lifelong antiepileptic drug (AED) treatment. We therefore wanted to determine how many patients attending our epilepsy service with JAE or JME went into 2 year remission, and then relapsed, both off and on AEDs. Method This was a retrospective case-notes review. Patients with JAE and JME were systematically ascertained from clinic lists and databases at one teaching hospital. Data was extracted systematically. Simple descriptive statistics were used. Results JAE: 14/36 (39%) were seizure free on AEDs for at least 2 years. Of the 6 (43%) attempting AED withdrawal, all (100%) relapsed, compared with only 25% of those who did not withdraw AEDs. Only 2/5 who relapsed and restarted AEDs regained remission. JME: 32/145 (22%) were seizure free on AEDs for at least 2 years. Of the 10 (31%) attempting AED withdrawal, 8 (80%) relapsed, compared with only 36% of those who did not withdraw AEDs. Only 2/8 who relapsed and restarted AEDs regained remission. Conclusion Remission rates for JAE and JME was lower than expected. Higher proportions of seizure free patients underwent physician-supervised withdrawal than anticipated. Relapse rates off AEDs were similar for JAE and JME, and at least twice as high as for those remaining on AEDs, and a further remission was not invariable on restarting AEDs. Our experience, comparing relapse in those withdrawing to those staying on AEDs will help in discussions with patients keen to try AED withdrawal. Elsevier 2018-07 Article PeerReviewed Healy, Liam, Moran, Maria, Singhal, Sumeet, O'Donoghue, Michael F, Alzoubidi, Rania and Whitehouse, William P. (2018) Relapse after treatment withdrawal of antiepileptic drugs for juvenile absence epilepsy and juvenile myoclonic epilepsy. Seizure, 59 . pp. 116-122. ISSN 1059-1311 Absence seizures; Generalised seizures; Myoclonic epilepsy; Adolescent; Juvenile; adult; Antiepileptic drugs https://www.sciencedirect.com/science/article/pii/S1059131118301328 doi:10.1016/j.seizure.2018.05.015 doi:10.1016/j.seizure.2018.05.015 |
| spellingShingle | Absence seizures; Generalised seizures; Myoclonic epilepsy; Adolescent; Juvenile; adult; Antiepileptic drugs Healy, Liam Moran, Maria Singhal, Sumeet O'Donoghue, Michael F Alzoubidi, Rania Whitehouse, William P. Relapse after treatment withdrawal of antiepileptic drugs for juvenile absence epilepsy and juvenile myoclonic epilepsy |
| title | Relapse after treatment withdrawal of antiepileptic drugs for juvenile absence epilepsy and juvenile myoclonic epilepsy |
| title_full | Relapse after treatment withdrawal of antiepileptic drugs for juvenile absence epilepsy and juvenile myoclonic epilepsy |
| title_fullStr | Relapse after treatment withdrawal of antiepileptic drugs for juvenile absence epilepsy and juvenile myoclonic epilepsy |
| title_full_unstemmed | Relapse after treatment withdrawal of antiepileptic drugs for juvenile absence epilepsy and juvenile myoclonic epilepsy |
| title_short | Relapse after treatment withdrawal of antiepileptic drugs for juvenile absence epilepsy and juvenile myoclonic epilepsy |
| title_sort | relapse after treatment withdrawal of antiepileptic drugs for juvenile absence epilepsy and juvenile myoclonic epilepsy |
| topic | Absence seizures; Generalised seizures; Myoclonic epilepsy; Adolescent; Juvenile; adult; Antiepileptic drugs |
| url | https://eprints.nottingham.ac.uk/51980/ https://eprints.nottingham.ac.uk/51980/ https://eprints.nottingham.ac.uk/51980/ |