Skip to main content
Log in

Correlation between EEG during AED withdrawal and epilepsy recurrence: a meta-analysis

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

To assess the risk of epilepsy recurrence after withdrawal from antiepileptic drugs (AEDs), researchers extensively studied recurrence-related risk factors, including electroencephalogram (EEG) during AED withdrawal. The relationship between EEG and epilepsy recurrence is controversial. We used meta-analysis to determine the correlation between EEG during AED withdrawal and epilepsy recurrence. A total of seven studies met the criteria for inclusion. The Newcastle–Ottawa Scale was used to conduct the research quality evaluation. Seven hundred three patients were included in meta-analysis. Patients with abnormal EEGs during withdrawal had a higher recurrence rate than patients with normal EEGs. Abnormal EEGs during withdrawal were a risk factor for recurrence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ngugi AK, Bottomley C, Kleinschmidt I, Sander JW, Newton CR (2010) Estimation of the burden of active and life-time epilepsy: a meta-analytic approach. Epilepsia 51(5):883–890. https://doi.org/10.1111/j.1528-1167.2009.02481.x

    Article  PubMed  PubMed Central  Google Scholar 

  2. Sillanpaa M, Schmidt D (2006) Natural history of treated childhood-onset epilepsy: prospective, long-term population-based study. Brain 129(Pt 3):617–624. https://doi.org/10.1093/brain/awh726

    Article  PubMed  Google Scholar 

  3. Kwan P, Brodie MJ (2000) Early identification of refractory epilepsy. N Engl J Med 342(5):314–319. https://doi.org/10.1056/NEJM200002033420503

    Article  CAS  PubMed  Google Scholar 

  4. Shih JJ, Ochoa JG (2009) A systematic review of antiepileptic drug initiation and withdrawal. Neurologist 15(3):122–131. https://doi.org/10.1097/NRL.0b013e3181901ad3

    Article  PubMed  Google Scholar 

  5. Berg AT, Shinnar S (1994) Relapse following discontinuation of antiepileptic drugs: a meta-analysis. Neurology 44(4):601–608

    Article  CAS  PubMed  Google Scholar 

  6. Specchio LM, Beghi E (2004) Should antiepileptic drugs be withdrawn in seizure-free patients? CNS Drugs 18(4):201–212. https://doi.org/10.2165/00023210-200418040-00001

    Article  CAS  PubMed  Google Scholar 

  7. Specchio LM, Tramacere L, La Neve A, Beghi E (2002) Discontinuing antiepileptic drugs in patients who are seizure free on monotherapy. J Neurol Neurosurg Psychiatry 72(1):22–25

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Tang X, Yu P, Ding D, Ge Y, Shi Y, Wang P, Zhu G, Hong Z (2017) Risk factors for seizure reoccurrence after withdrawal from antiepileptic drugs in individuals who have been seizure-free for over 2 years. PLoS One 12(8):e0181710. https://doi.org/10.1371/journal.pone.0181710

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Schmidt D, Sillanpaa M (2017) Stopping epilepsy treatment in seizure remission: good or bad or both? Seizure 44:157–161. https://doi.org/10.1016/j.seizure.2016.09.003

    Article  PubMed  Google Scholar 

  10. Shinnar S, Vining EP, Mellits ED, D’Souza BJ, Holden K, Baumgardner RA, Freeman JM (1985) Discontinuing antiepileptic medication in children with epilepsy after two years without seizures. A prospective study. N Engl J Med 313(16):976–980. https://doi.org/10.1056/nejm198510173131603

    Article  CAS  PubMed  Google Scholar 

  11. Li W, Si Y, Zou XM, An DM, Yang H, Zhou D (2014) Prospective study on the withdrawal and reinstitution of antiepileptic drugs among seizure-free patients in West China. J Clin Neurosci 21(6):997–1001. https://doi.org/10.1016/j.jocn.2013.09.019

    Article  PubMed  Google Scholar 

  12. Overweg J, Binnie CD, Oosting J, Rowan AJ (1987) Clinical and EEG prediction of seizure recurrence following antiepileptic drug withdrawal. Epilepsy Res 1(5):272–283

    Article  CAS  PubMed  Google Scholar 

  13. Medical Research Council Antiepileptic Drug Withdrawal Study Group (1993) Prognostic index for recurrence of seizures after remission of epilepsy. BMJ 306(6889):1374–1378

  14. Dooley J, Gordon K, Camfield P, Camfield C, Smith E (1996) Discontinuation of anticonvulsant therapy in children free of seizures for 1 year: a prospective study. Neurology 46(4):969–974

    Article  CAS  PubMed  Google Scholar 

  15. Braathen G, Melander H (1997) Early discontinuation of treatment in children with uncomplicated epilepsy: a prospective study with a model for prediction of outcome. Epilepsia 38(5):561–569

    Article  CAS  PubMed  Google Scholar 

  16. Geerts AT, Niermeijer JM, Peters AC, Arts WF, Brouwer OF, Stroink H, Peeters EA, van Donselaar CA (2005) Four-year outcome after early withdrawal of antiepileptic drugs in childhood epilepsy. Neurology 64(12):2136–2138. https://doi.org/10.1212/01.wnl.0000166035.26217.61

    Article  CAS  PubMed  Google Scholar 

  17. Lamberink HJ, Otte WM, Geerts AT, Pavlovic M, Ramos-Lizana J, Marson AG, Overweg J, Sauma L, Specchio LM, Tennison M, Cardoso TMO, Shinnar S, Schmidt D, Geleijns K, Braun KPJ (2017) 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 16(7):523–531. https://doi.org/10.1016/s1474-4422(17)30114-x

    Article  PubMed  Google Scholar 

  18. Galimberti CA, Manni R, Parietti L, Marchioni E, Tartara A (1993) Drug withdrawal in patients with epilepsy: prognostic value of the EEG. Seizure 2(3):213–220

    Article  CAS  PubMed  Google Scholar 

  19. Todt H (1984) The late prognosis of epilepsy in childhood: results of a prospective follow-up study. Epilepsia 25(2):137–144

    Article  CAS  PubMed  Google Scholar 

  20. Verrotti A, Morresi S, Cutarella R, Morgese G, Chiarelli F (2000) Predictive value of EEG monitoring during drug withdrawal in children with cryptogenic partial epilepsy. Neurophysiol Clin 30(4):240–245

    Article  CAS  PubMed  Google Scholar 

  21. Eadie MJ (1994) Epileptic seizures in 1902 patients: a perspective from a consultant neurological practice (1961-1991). Epilepsy Res 17(1):55–79

    Article  CAS  PubMed  Google Scholar 

  22. Pavlovic M, Jovic N, Pekmezovic T (2012) Withdrawal of antiepileptic drugs in young patients with cryptogenic focal epilepsies. Seizure 21(6):431–436. https://doi.org/10.1016/j.seizure.2012.04.008

    Article  PubMed  Google Scholar 

  23. Su L, Di Q, Yu N, Zhang Y (2013) Predictors for relapse after antiepileptic drug withdrawal in seizure-free patients with epilepsy. J Clin Neurosci 20(6):790–794. https://doi.org/10.1016/j.jocn.2012.07.010

    Article  PubMed  Google Scholar 

  24. Pavlovic M, Jovic N, Pekmezovic T (2011) Antiepileptic drugs withdrawal in patients with idiopathic generalized epilepsy. Seizure 20(7):520–525. https://doi.org/10.1016/j.seizure.2011.03.007

    Article  PubMed  Google Scholar 

  25. Tinuper P, Avoni P, Riva R, Provini F, Lugaresi E, Baruzzi A (1996) The prognostic value of the electroencephalogram in antiepileptic drug withdrawal in partial epilepsies. Neurology 47(1):76–78

    Article  CAS  PubMed  Google Scholar 

  26. Tang L, Xiao Z (2017) Can electroencephalograms provide guidance for the withdrawal of antiepileptic drugs: a meta-analysis. Clin Neurophysiol 128(2):297–302. https://doi.org/10.1016/j.clinph.2016.11.024

    Article  PubMed  Google Scholar 

  27. Procaccianti G et al (1987) Antiepileptic drug withdrawal: preliminary results of a prospective study. Advances in Epileptology 16(7):379–373

    Google Scholar 

  28. Ueda S, Ishida S, Nakazawa Y (1989) Analyses of epileptics who have been intractable but entered prolonged remission afterwards without medications. Jpn J Psychiatry Neurol 43(3):507–508

    CAS  PubMed  Google Scholar 

  29. Nakazawa Y, Ishida S, Maeda H, Sakurai S, Motooka H (1995) Prognosis of epilepsy withdrawn from antiepileptic drugs. Psychiatry Clin Neurosci 49(3):163–168

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This study was supported by the National Natural Science Foundation of China (grant number 81071040, 81471320).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zheng Xiao.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yao, J., Wang, H. & Xiao, Z. Correlation between EEG during AED withdrawal and epilepsy recurrence: a meta-analysis. Neurol Sci 40, 1637–1644 (2019). https://doi.org/10.1007/s10072-019-03855-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-019-03855-x

Keywords

Navigation