Discontinuation of medications after successful epilepsy surgery in children.

Abstract:

:To evaluate the need for antiepileptic drugs after successful epilepsy surgery in pediatric patients, we retrospectively reviewed patients who had epilepsy surgery and were seizure free or had rare nondisabling auras during the first 6 postoperative months. Association between drug discontinuation and seizure recurrence was evaluated using Cox proportional hazards multivariable survival analysis. Medications were withdrawn in 68 of 97 patients, seizure free (or with rare nondisabling auras) for >6 months after surgery; 57 of the 68 (84%) remained seizure free; the other 11 (16%) had seizure recurrence after 68 months (median). Seizure recurrence was controlled with medication in 7 of the 11 patients (3 have rare seizures, 1 frequent auras). Discontinuing medications at <6 mo, compared with later or no withdrawal, had significant risk for seizure recurrence (hazard ratio 5.8; 95% confidence interval 1.8, 17.5; P = 0.003). Of 29 patients who continued drugs, 28 (97%) remained seizure free after 37 months (median). Freedom from seizures 6 months after surgery predicted good outcome (95% seizure free, with or without medication). If discontinuation is offered after 6 months, the majority of patients (84%) can be expected to remain seizure free with no further need for medication. Although seizure breakthrough is possible in a smaller percentage, restarting drugs is likely to restore seizure control.

journal_name

Pediatr Neurol

journal_title

Pediatric neurology

authors

Lachhwani DK,Loddenkemper T,Holland KD,Kotagal P,Mascha E,Bingaman W,Wyllie E

doi

10.1016/j.pediatrneurol.2008.01.010

subject

Has Abstract

pub_date

2008-05-01 00:00:00

pages

340-4

issue

5

eissn

0887-8994

issn

1873-5150

pii

S0887-8994(08)00058-1

journal_volume

38

pub_type

杂志文章
  • An MRI and MRS study of Pelizaeus-Merzbacher disease.

    abstract::Earlier reports on T2-weighted magnetic resonance imaging (MRI) in the classical form of Pelizaeus-Merzbacher disease seemed to divide the patterns of the high-intensity lesions in the white matter into three subtypes: type I, diffusely hemispheric and corticospinal; type II, diffusely hemispheric without brainstem le...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/s0887-8994(97)00212-9

    authors: Nezu A,Kimura S,Takeshita S,Osaka H,Kimura K,Inoue K

    更新日期:1998-04-01 00:00:00

  • Toxicity of Salvia officinalis in a newborn and a child: an alarming report.

    abstract::Although it is widely believed that herbal products are beneficial to the health, some herbal products can result in serious adverse effects, such as epileptic seizures, especially in children who are particularly susceptible. Sage oil contains well-known convulsant substances such as thujone, camphor, and cineole in ...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/j.pediatrneurol.2011.05.012

    authors: Halicioglu O,Astarcioglu G,Yaprak I,Aydinlioglu H

    更新日期:2011-10-01 00:00:00

  • Cerebral perfusion pressure monitoring in premature newborns.

    abstract::Cerebral perfusion pressure (CPP), believed to be a major determinant of neurologic outcome, was monitored at the bedside of high-risk premature newborns during the first few days of life. Intraventricular hemorrhage was presumed to have occurred in only one of the seven infants and was associated with ventriculomegal...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/0887-8994(86)90048-2

    authors: Braun MA,Rosman NP,Gould JB

    更新日期:1986-07-01 00:00:00

  • Congenital neuropathy with the absence of large myelinated fibers.

    abstract::Twelve patients with hereditary motor and sensory neuropathy with the absence of large myelinated fibers have been reported. All of these patients had central nervous system involvement. In this report, we describe the first patient with pure motor and sensory neuropathy with the absence of large myelinated fibers wit...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/s0887-8994(00)00192-2

    authors: Fukuda M,Morimoto T,Suzuki Y,Kida K,Ohnishi A

    更新日期:2000-10-01 00:00:00

  • Measles-vaccinated Israeli boy with subacute sclerosing panencephalitis.

    abstract::Subacute sclerosing panencephalitis is a rare neurologic disorder of childhood and adolescence. We describe a 16-year-old boy who manifested the disease despite proper vaccinations. He was hospitalized because of bedwetting, involuntary limb movements, abnormal speech, and balance disturbances. Immunoglobulin G antibo...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/j.pediatrneurol.2011.01.011

    authors: Har-Even R,Aichenbaum S,Rabey JM,Livne A,Bistritzer T

    更新日期:2011-06-01 00:00:00

  • The effect of topiramate on body weight and ghrelin, leptin, and neuropeptide-Y levels of prepubertal children with epilepsy.

    abstract:BACKGROUND:Weight loss is one of the most frequent side effects of topiramate treatment. The aim of our study was to investigate the effect of topiramate on body mass index, serum glucose, insulin, cortisol, leptin, and neuropeptide-Y levels and the role of these variables on the pathogenesis of weight loss in prepuber...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/j.pediatrneurol.2014.05.001

    authors: Ozcelik AA,Serdaroglu A,Bideci A,Arhan E,Soysal Ş,Demir E,Gücüyener K

    更新日期:2014-08-01 00:00:00

  • Alterations in myelin formation in fetal brains of twins.

    abstract::Insufficient nutrition is known to lead to disturbances in postnatal myelin formation. This study aims to demonstrate that early myelination is altered in human twin pregnancies. Five brains of twins with a symmetric blood supply and three brains of twins with chronic fetal-fetal transfusion syndrome (one hypervolemic...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/s0887-8994(98)00068-x

    authors: Ulfig N,Nickel J,Saretzki U

    更新日期:1998-10-01 00:00:00

  • Pediatric Cerebral Cavernous Malformations.

    abstract::Cerebral cavernous malformations are the second most common vascular malformations in the central nervous system, and over one-third are found in children. Lesions may be solitary or multiple, be discovered incidentally, be sporadic, or be secondary to familial cavernomatosis or radiation therapy. Children may present...

    journal_title:Pediatric neurology

    pub_type: 杂志文章,评审

    doi:10.1016/j.pediatrneurol.2020.11.004

    authors: Paddock M,Lanham S,Gill K,Sinha S,Connolly DJA

    更新日期:2020-11-27 00:00:00

  • Hemiconvulsion-hemiplegia-epilepsy syndrome associated with CACNA1A S218L mutation.

    abstract::Hemiconvulsion-hemiplegia-epilepsy syndrome involves sudden and prolonged unilateral seizures, followed by transient or permanent hemiplegia and epilepsy during infancy or early childhood. Some patients with familial hemiplegic migraine and demonstrating the S218L mutation in CACNA1A experience severe attacks with uni...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/j.pediatrneurol.2011.04.010

    authors: Yamazaki S,Ikeno K,Abe T,Tohyama J,Adachi Y

    更新日期:2011-09-01 00:00:00

  • Brainstem gangliogliomas.

    abstract::Gangliogliomas are rare neurogliogenic tumors of the central nervous system. Primary involvement of the brainstem is characterized by variable presentations and a long clinical course before diagnosis. Identification of this group of tumors is essential because clinical improvement and prolonged survival have been doc...

    journal_title:Pediatric neurology

    pub_type: 杂志文章,评审

    doi:10.1016/0887-8994(86)90014-7

    authors: Martin LD,Kaplan AM,Hernried LS,Fisher BJ

    更新日期:1986-05-01 00:00:00

  • Suicide Screening in Sturge-Weber Syndrome: An Important Issue in Need of Further Study.

    abstract:BACKGROUND:Sturge-Weber syndrome is a neurocutaneous disorder associated with epilepsy, glaucoma, cognitive impairments, and a port-wine birthmark. Although individuals with Sturge-Weber syndrome are vulnerable to known risk factors for suicide, including chronic illness and physical differences (port-wine birthmark), ...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/j.pediatrneurol.2020.03.013

    authors: Sebold AJ,Ahmed AS,Ryan TC,Cohen BA,Jampel HD,Suskauer SJ,Zabel TA,Comi AM,Rybczynski S

    更新日期:2020-09-01 00:00:00

  • Myotoxicity of lipid-lowering agents in a teenager with MELAS mutation.

    abstract::The use of lipid-lowering statins has been associated with raised serum muscle enzymes and, occasionally, with rhabdomyolysis, especially in patients with pre-existing metabolic myopathies. The A3243G mutation is one of the most common mutations associated with mitochondrial disorders. A teenager harboring the A3243G ...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/j.pediatrneurol.2008.09.002

    authors: Tay SK,Dimauro S,Pang AY,Lai PS,Yap HK

    更新日期:2008-12-01 00:00:00

  • Neurophysiologic studies and MRI in Pelizaeus-Merzbacher disease: comparison of classic and connatal forms.

    abstract::Four patients with the classic form and 1 patient with the connatal form of Pelizaeus-Merzbacher disease were studied with magnetic resonance imaging, electroencephalography, and multimodal evoked potentials, including brainstem auditory evoked potentials, somatosensory evoked potentials, and visual evoked potentials....

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/0887-8994(94)00124-k

    authors: Wang PJ,Young C,Liu HM,Chang YC,Shen YZ

    更新日期:1995-01-01 00:00:00

  • Ring chromosome 20: a pediatric potassium channelopathy responsive to treatment with ezogabine.

    abstract:BACKGROUND:Ring chromosome 20 is a genetic disorder characterized by intractable epilepsy, behavioral problems, and cognitive deficit. The potassium channel-coding gene KCNQ2 is localized at the locus q13.3 on the chromosome 20, the most common site where the ring occurs. Ezogabine is the first potassium channel opener...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/j.pediatrneurol.2013.06.005

    authors: Walleigh DJ,Legido A,Valencia I

    更新日期:2013-11-01 00:00:00

  • Opsoclonus-myoclonus syndrome with abnormal single photon emission computed tomography imaging.

    abstract::The single photon emission computed tomography (SPECT) findings in 2 patients with opsoclonus-myoclonus syndrome (OMS) who had similar symptoms in the acute stage of the disease are described. In 1 patient with encephalitis, SPECT showed increased blood flow in most of the cerebellum; the highest accumulation of the r...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/s0887-8994(97)00031-3

    authors: Oguro K,Kobayashi J,Aiba H,Hojo H

    更新日期:1997-05-01 00:00:00

  • Moyamoya vascular pattern in Alagille syndrome.

    abstract::We describe a girl with Alagille syndrome and a moyamoya angiographic pattern on magnetic resonance angiography. She was referred for genetic consultation because of posterior embryotoxon and peripheral pulmonary stenosis. Her facial appearance was typical, but she had no cholestasis or vertebral involvement. A hetero...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/j.pediatrneurol.2012.04.014

    authors: Rocha R,Soro I,Leitão A,Silva ML,Leão M

    更新日期:2012-08-01 00:00:00

  • A Cross-sectional Survey of Growth and Nutritional Status in Children With Cerebral Palsy in West China.

    abstract:BACKGROUND:We describe the growth and nutritional status of children with cerebral palsy (2 to 18 years old) in West China and to explore the correlation between the nutritional status and age, gender, and gross and fine motor function. METHODS:We performed a cross-sectional survey of children registered as having cer...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/j.pediatrneurol.2016.01.002

    authors: Wang F,Cai Q,Shi W,Jiang H,Li N,Ma D,Wang Q,Luo R,Mu D

    更新日期:2016-05-01 00:00:00

  • Epidermal nevus syndrome with azygos anterior cerebral artery.

    abstract::Epidermal nevus syndrome is a neurocutaneous disorder characterized by the association of epidermal nevi with central nervous system or skeletal abnormalities. Central nervous system abnormalities include hemimegalencephaly, hydrocephalus, various migration disorders, intraspinal lipomas, and enlarged spinal roots. Ra...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/j.pediatrneurol.2008.06.016

    authors: Kara B,Inan N,Bayramgürler D,Altintaş O,Akbulut A

    更新日期:2008-10-01 00:00:00

  • Outcome of brain abscess treatment in children: reduced morbidity with neuroimaging.

    abstract::Records were reviewed of 17 patients, ages 4 months to 18 years, who had been diagnosed as having brain abscesses between 1975-1984. Serial computed tomography was used to guide treatment; consequently, 8 patients were managed medically and 9 received surgical intervention. All medically treated patients were free of ...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/0887-8994(87)90080-4

    authors: Ferriero DM,Derechin M,Edwards MS,Berg BO

    更新日期:1987-05-01 00:00:00

  • Fragile X syndrome in Japanese patients with infantile autism.

    abstract::Forty-seven patients (39 boys and 8 girls) with infantile autism whose clinical symptoms had matched the diagnostic criteria of DSM III were studied cytogenetically for the occurrence of fragile X [fra(X)] syndrome. The existence of fra(X) chromosome in these patients was screened first by culturing peripheral blood l...

    journal_title:Pediatric neurology

    pub_type: 杂志文章,评审

    doi:10.1016/0887-8994(87)90069-5

    authors: Matsuishi T,Shiotsuki Y,Niikawa N,Katafuchi Y,Otaki E,Ando H,Yamashita Y,Horikawa M,Urabe F,Kuriya N

    更新日期:1987-09-01 00:00:00

  • Seizures associated with calcifications and edema in neurocysticercosis.

    abstract::We describe eight cases of pediatric patients whose neuroimages performed after seizures revealed abnormalities that were compatible with edema surrounding calcified lesions and which disappeared in subsequent examinations. ...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/s0887-8994(01)00324-1

    authors: Antoniuk SA,Bruck I,Dos Santos LH,Pintarelli VL,Navolar FB,Brackmann PC Jr,de Morais RL

    更新日期:2001-10-01 00:00:00

  • Neonatal seizures: do they damage the brain?

    abstract::Seizures are an early sign of brain injury in newborns. These seizures are in most cases repetitive or associated with asymptomatic electrographic seizures. Despite the relative resistance of the immature brain to seizure-induced brain damage, there is more and more evidence that neonatal seizures impair normal brain ...

    journal_title:Pediatric neurology

    pub_type: 杂志文章,评审

    doi:10.1016/j.pediatrneurol.2008.10.026

    authors: Thibeault-Eybalin MP,Lortie A,Carmant L

    更新日期:2009-03-01 00:00:00

  • Late Cerebrovascular Complications After Radiotherapy for Childhood Primary Central Nervous System Tumors.

    abstract:BACKGROUND:Brain radiotherapy plays a central role in the treatment of certain types of childhood primary central nervous system tumors. However, damage to surrounding normal brain tissue causes different acute and chronic medical and neurological complications. Despite the expected increase in number of childhood prim...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/j.pediatrneurol.2015.05.015

    authors: Passos J,Nzwalo H,Marques J,Azevedo A,Netto E,Nunes S,Salgado D

    更新日期:2015-09-01 00:00:00

  • Sixth nerve palsies in children.

    abstract::The causes of sixth nerve palsies in 75 children, all of whom had undergone modern neuroimaging, were reviewed. Neoplasms or their neurosurgical removal was the most common cause (n = 34 [45%]); elevated intracranial pressure (nontumor) (15%), traumatic (12%), congenital (11%), inflammatory (7%), miscellaneous (5%), a...

    journal_title:Pediatric neurology

    pub_type: 杂志文章,评审

    doi:10.1016/s0887-8994(98)00090-3

    authors: Lee MS,Galetta SL,Volpe NJ,Liu GT

    更新日期:1999-01-01 00:00:00

  • Neuropathology of two fatal cases of measles in the 1988-1989 Houston epidemic.

    abstract::The clinical course and autopsy findings of 2 patients with measles encephalitis that occurred during the 1988-1989 Houston epidemic are reported. A previously healthy 25-month-old boy had serologically-proved measles, hemophagocytic syndrome, and acute disseminated demyelinating encephalitis. A 19-year-old male with ...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/0887-8994(90)90046-4

    authors: Pearl PL,Abu-Farsakh H,Starke JR,Dreyer Z,Louis PT,Kirkpatrick JB

    更新日期:1990-03-01 00:00:00

  • Ratio of Alpha 2-Macroglobulin Levels in Cerebrospinal Fluid and Serum: An Expression of Neuroinflammation in Acute Disseminated Encephalomyelitis.

    abstract:BACKGROUND:Acute encephalitis and encephalopathy are life-threatening diseases in children. However, no laboratory examinations are performed for their early diagnosis and treatment. Alpha 2-macroglobulin (α2M) is a blood glycoprotein that increases during the early stages of inflammation. In the present study, we inve...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/j.pediatrneurol.2019.04.020

    authors: Suzuki Y,Hashimoto K,Hoshi K,Ito H,Kariya Y,Miyazaki K,Sato M,Kawasaki Y,Yoshida M,Honda T,Hashimoto Y,Hosoya M

    更新日期:2019-09-01 00:00:00

  • Quantitative follow-up analysis by computed tomographic imaging in neonatal hydrocephalus.

    abstract::We sought a simple and accurate method to monitor neonatal hydrocephalic infants using standard computed tomographic scans. Volume measurements were made by means of pixel counting using a personal computer and a drawing device, as a graphic tablet system, over computed tomographic scans of six infants with neonatal h...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/s0887-8994(03)00401-6

    authors: Morimoto K,Nishikuni K,Hirano S,Takemoto O,Futagi Y

    更新日期:2003-11-01 00:00:00

  • Cerebral vascular events associated with ulcerative colitis in children.

    abstract::Although peripheral vascular thrombic events are recognized as a serious extra-intestinal complication of inflammatory bowel disease, the occurrence of cerebral vascular events in association with acute exacerbations of this group of diseases is rare. In this article, relevant literature is reviewed and three children...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/s0887-8994(00)00264-2

    authors: Keene DL,Matzinger MA,Jacob PJ,Humphreys P

    更新日期:2001-03-01 00:00:00

  • Acute disseminated encephalomyelitis with probable measles vaccine failure.

    abstract::The patient is a 10-year-old male who experienced somnolence and incomplete quadriplegia after headache and vomiting, without exanthema, for 3 days. The clinical course and magnetic resonance imaging findings of the brain and spinal cord were compatible with acute disseminated encephalomyelitis. The serologic examinat...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/s0887-8994(99)00005-3

    authors: Nagai K,Mori T

    更新日期:1999-05-01 00:00:00

  • Dominant recurrent ataxia and vertigo of childhood.

    abstract::Four families are described with an autosomal dominant illness characterized by the childhood onset of recurrent attacks of prolonged ataxia, server vertigo, and vomiting. The attacks often begin in infancy. On the average, attacks occur monthly, and last between one hour to more than a week. Variations in severity oc...

    journal_title:Pediatric neurology

    pub_type: 杂志文章

    doi:10.1016/0887-8994(86)90037-8

    authors: Tibbles JA,Camfield PR,Cron CC,Farrell K

    更新日期:1986-01-01 00:00:00