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Discontinuing antiepileptic drugs in children with epilepsy. A comparison of a six-week and a nine-month taper period.

Publication ,  Journal Article
Tennison, M; Greenwood, R; Lewis, D; Thorn, M
Published in: N Engl J Med
May 19, 1994

BACKGROUND: The optimal regimen for discontinuing antiepileptic medications in children with epilepsy is unknown. METHODS: We randomly assigned 149 children to either a six-week or a nine-month period of drug tapering, after which therapy was discontinued. Each group was composed of patients who had been seizure-free for either two or four years before drug tapering was begun. Most patients were receiving one antiepileptic drug; none were taking more than two. The children were evaluated periodically during and after the taper period. Sixteen patients were lost to follow-up before the beginning of the taper period. Proportional-hazards regression analysis was used to assess the risk of seizure recurrence among the remaining 133 patients. RESULTS: Seizures recurred in 53 patients (40 percent). The mean duration of follow-up was 39 months (range, 11 to 105) for the patients who did not have a recurrence of seizures. Neither the length of the taper period (six weeks vs. nine months, P = 0.38) nor the length of time the patients were free of seizures before the taper period was begun (two years vs. four years, P = 0.20) significantly influenced the risk of seizure recurrence. The presence of mental retardation (relative risk, 3.1, 95 percent confidence interval, 1.5 to 6.2) or spikes in the electroencephalogram at the time of tapering (relative risk, 1.9, 95 percent confidence interval, 1.0 to 3.4) increased the risk of seizure recurrence. CONCLUSIONS: The risk of seizure recurrence during drug tapering and after the discontinuation of antiepileptic drug therapy in children with epilepsy is not different whether the medications are tapered over a six-week or a nine-month period.

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Published In

N Engl J Med

DOI

ISSN

0028-4793

Publication Date

May 19, 1994

Volume

330

Issue

20

Start / End Page

1407 / 1410

Location

United States

Related Subject Headings

  • Survival Analysis
  • Risk Factors
  • Recurrence
  • Prospective Studies
  • Proportional Hazards Models
  • Patient Compliance
  • Male
  • Humans
  • General & Internal Medicine
  • Follow-Up Studies
 

Citation

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ICMJE
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Tennison, M., Greenwood, R., Lewis, D., & Thorn, M. (1994). Discontinuing antiepileptic drugs in children with epilepsy. A comparison of a six-week and a nine-month taper period. N Engl J Med, 330(20), 1407–1410. https://doi.org/10.1056/NEJM199405193302002
Tennison, M., R. Greenwood, D. Lewis, and M. Thorn. “Discontinuing antiepileptic drugs in children with epilepsy. A comparison of a six-week and a nine-month taper period.N Engl J Med 330, no. 20 (May 19, 1994): 1407–10. https://doi.org/10.1056/NEJM199405193302002.
Tennison M, Greenwood R, Lewis D, Thorn M. Discontinuing antiepileptic drugs in children with epilepsy. A comparison of a six-week and a nine-month taper period. N Engl J Med. 1994 May 19;330(20):1407–10.
Tennison, M., et al. “Discontinuing antiepileptic drugs in children with epilepsy. A comparison of a six-week and a nine-month taper period.N Engl J Med, vol. 330, no. 20, May 1994, pp. 1407–10. Pubmed, doi:10.1056/NEJM199405193302002.
Tennison M, Greenwood R, Lewis D, Thorn M. Discontinuing antiepileptic drugs in children with epilepsy. A comparison of a six-week and a nine-month taper period. N Engl J Med. 1994 May 19;330(20):1407–1410.
Journal cover image

Published In

N Engl J Med

DOI

ISSN

0028-4793

Publication Date

May 19, 1994

Volume

330

Issue

20

Start / End Page

1407 / 1410

Location

United States

Related Subject Headings

  • Survival Analysis
  • Risk Factors
  • Recurrence
  • Prospective Studies
  • Proportional Hazards Models
  • Patient Compliance
  • Male
  • Humans
  • General & Internal Medicine
  • Follow-Up Studies