국소 겉질 형성이상으로 인한 소아 뇌전증 환자에서 뇌전증 수술후 항경련제 복용 중단

• 영문명: Discontinuing Antiepileptic Drugs after Pediatric Epilepsy Surgery for Focal Cortical Dysplasia
• 발행기관: 대한소아신경학회
• 저자명: 서세은() 김세희() 김동석() 강훈철() 이준수() 김흥동()
• 간행물 정보: 『Annals of Child Neurology(구 대한소아신경학회지)』대한소아신경학회지 제25권 제3호, 127~132쪽, 전체 6쪽
• 주제분류: 의약학 > 소아과학
• 파일형태: PDF
• 발행일자: 2017.07.30

영문 초록

Purpose: Antiepileptic drugs (AEDs) can be discontinued in a subset of patients after surgery. We aimed to identify the factors related to successful AED withdrawal after surgery in pediatric patients with focal cortical dysplasia (FCD). Methods: The study included 134 patients who underwent resective surgery for FCD at Severance Hospital between 2003 and 2014. Age of seizure onset, epilepsy duration, and location and histopathological classification of the FCD were compared between patients who experienced seizure recurrence and those who did not. The interval between surgery and initiation of AED reduction was also compared. Results: In total, 134 patients were included. The median age at seizure onset was 1.0 year (interquartile range [IQR], 0.3–5.0). The median follow-up duration was 6.0 years (IQR, 1.0–13.0). AED withdrawal was attempted in 89 (66%), and 61 (69%) patients remained seizure-free. Of 61 patients, 38 (62%) were successfully weaned off all AEDs. Seizures recurred in 28 (31%) patients. The mean duration between surgery and initiation of AED reduction did not significantly differ between the seizure recurrence (4.5 months, IQR, 2.7–8.7) and non-recurrence groups (1.9 months, IQR, 0.5–5.4) (P<0.006). Patients who had FCD type IIb (39% vs. 7%, P=0.004) were more likely to be in the non-recurrence group than in the recurrence group (P=0.031). Conclusion: Surgical resection offers patients with FCD an opportunity to completely discontinue their AEDs. Early AED discontinuation may be pursued in patients with FCD in cases of complete resection.

키워드

Focal cortical dysplasia Epilepsy surgery Pediatric Antiepileptic drugs Withdraw Reduce