Abstract;

Background: Relapsing seizures following discontinuation of anti-seizure drugs (ASDs) has been the focus of several researches in the recent years. This research aimed to identify the predictive factors of seizure recurrence after anti-seizure drugs withdrawal among epileptic patients who had achieved two years seizures remission. Methods: A total of 60 epileptic patients who had achieved two years seizures remission and began ASDs withdrawal were followed prospectively for one year. The patients were divided into two groups; patients with and without relapsed seizures. Clinical and demographic details were recorded. National Hospital Seizure Severity Scale (NHS3) was used to assess the severity of epilepsy. Regular Electroencephalogram (EEG) monitoring was done. Anxiety and depressive symptoms were assessed by using generalized anxiety disorder 7 (GAD7) and Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) scales respectively. Results: Risk of post-withdrawal relapsed seizures increased with; history of status epilepticus (p=0.002), focal seizures (p=0.005), late remission of initial epileptic seizures (p=0.002), delay of ASD therapy (p<0.001), Poly-therapy (p<0.001), post-withdrawal epileptiform EEG (p<0.001), high NHS3,GAD7, NDDI-E scores (p<0.001) Conclusion: Risk of relapsing seizures after ASDs withdrawal during the first year was 60%. The decision to withdraw ASDs necessitates individual evaluation of each case with accurate assessment of risk factors associating with relapsed seizures.

Keywords: Relapsed seizures, Predictors, Drug withdrawal