| Objective:To summarize the recurrence of epilepsy patients treated by antiepileptic drugs(AEDs)and the regular withdrawal of drugs,and to analyze the relevant risk factors.Methods:A retrospective analysis of 221 patients with epilepsy in the XX Hospital from January 2001 to December 2011 for at least 3 years of no seizure and regular withdrawal.Follow-up visits to December 1,2016 to observe whether recurrence and the presence of incentives,and when to relapse.Which lost access to 51 cases,a total of 170 cases were visited,the observation period ranging from 2 to 11 years.Clinical data were collected as follows:sex,age,family history,febrile seizures(FS)history,imaging,status epilepticus(SE),etiology,type of seizures,frequency of seizures,complete control of the use of non-episode drug types,no pre-onset course,electroencephalogram(electroencephalogram,EEG),etc.The SPSS 19.0 was used for statistical analysis.Results:A total of 170 patients with epilepsy withdrawal,of which 61 cases of recurrence,and the recurrence rate was 35.9%.1.The recurrence rate was 39.34%at 0-6 months after drug withdrawal,24.59%at 6-12 months after withdrawal,16.39%at 12-18 months after withdrawal,16.39%at 18-24 months after withdrawal,and more than 24 months after withdrawal was 9.84%.2.There were 87 males in the male group,and the recurrence rate was 26.44%.However,the female group included 83 and the recurrence rate was 45.78%.There was a statistical difference(P<0.05),which means that women after the withdrawal of drugs than men easy to relapse.3.Age of onset:The recurrence rate was 33.33%in the 0-18 year group and 33.33%in the 18-60 year group.The recurrence rate was 20.00%in the group of more than 60 years old.There was no statistical difference(P>0.05),which it means that no matter when the patient onset,the recurrence rate after withdrawal were no difference.Discontinued year old group:The recurrence rate was 30.43%in the aged 14-18 year group and 41.90%in the 18-60 year old group.The recurrence rate was 23.81%in the group of 60 years.There was no statistically significant difference(P>0.05),meaning that the patient was withdrawn at any age,and the recurrence rate was not different.4.The presence of epilepsy family history group recurrence rate of 47.83%,and no family history group recurrence rate of 34.25%.There was no statistical difference(P>0.05),which means that regardless of the existence of family history of patients,the recurrence rate after withdrawal was no difference.5.There was a recurrence rate of 61.54%in FS group and 33.76%in group without FS.There was a statistical difference(P<0.05),which means that the history of FS than those without history of FS easy to relapse.6.The recurrence rate was 36.99%in patients with abnormal imaging and 35.05%in patients with normal imaging.There was no statistical difference(P>0.05),which means that regardless of nerve imaging abnormalities or not,the recurrence rate after withdrawal was no difference.7.There was a recurrence rate of 40.00%in patients with primary epilepsy and 31.76%in patients with symptomatic epilepsy.There was no statistical difference(P>0.05),which means that regardless of the presence of the cause,the recurrence rate after withdrawal was no difference.8.The recurrence rate was 41.25%in the partial seizure group,39.71%in the general attack group,and 44.00%in the partial attack group and the comprehensive attack group.There is no statistical difference(P>0.05),which means that no matter what type of attack patients,the recurrence rate after withdrawal were no difference.The recurrence rate was 37.86%in a seizure type group and 32.26%in a variety of episodes.There was no statistical difference(P>0.05),which means that regardless of whether there were a variety of patients with seizures form,the recurrence rate after withdrawal were no difference.9.The recurrence rate was 24.69%in patients with episodes less than 5 times/year.However,the recurrence rate was 46.07%in patients with a frequency greater than 5 times/year.There was a statistical difference(P<0.05),which means that the frequency of attack was greater than 5 times/year than less than 5 times/year easy to relapse.10.The recurrence rate was 46.15%in SE group and 34.03%in group without SE.There was a statistical difference(P<0.05),meaning that the presence of SE patients in the course of disease than non-SE patients prone to recurrence.11.The relapse rate was 36.36%in the single drug group and 37.50%in the combined group.There was no statistical difference(P>0.05),which means that regardless of whether the patient was a single drug or combination therapy,the recurrence rate after the withdrawal was no difference.12.The recurrence rate was 25.81%in the preoperative course and less than 5 years.There was a statistical difference(P<0.05),which means that no pre-onset disease was greater than 5 years less than 5 years prone to recurrence.13.There was no recurrence rate of 43.21%in the non-episodes of 3-4 years before withdrawal,and 28.26%recurrence rate was 28.26%in the non-episodic 4-5 years withdrawal group,and 28.89%in the non-seizure more than 5 years withdrawal group.There is no statistical difference(P>0.05),which means that regardless of withdrawal before the clinical onset time of 3-4 years or 4-5 years or more,the recurrence rate were no difference.14.The recurrence rate was 15.00%for the first EEG normal group and 38.67%for the first EEG abnormal group.There was a statistically significant difference(P<0.05),suggesting that patients with first EEG abnormalities were more likely to have recurrence than patients with normal EEG for the first time.The recurrence rate before the withdrawal of EEG normal group was 31.25%,and the EEG abnormal group was 44.83%.There was no statistical difference(P>0.05),which means that regardless of the patient before the withdrawal of EEG was abnormal,the recurrence rate was no difference.15.Multivariate regression analysis was used to analyze the factors of statistical differences in univariate analysis.The results showed that there were statistically significant differences in Female,the course of no seizure more than 5 years,and the frequency of seizures more than 5 times per year before the use of effective drugs.16.Recurrence of 28.51%of patients with incentives,including bad habits(stay up all night,drinking)accounted for 61.11%,upper respiratory tract infection with fever accounted for 16.67%,by the scare accounted for 11.11%,and pregnancy accounted for 11.11%.Conclusions:1.The recurrence rate of patients with epilepsy after withdrawal of antiepileptic drugs was 35.90%.2.After withdrawal highest relapse rate within 6 months,then gradually decreased,when the 18 months after the withdrawal recurrence rate was significantly reduced and substantially unchanged.3.Female,the course of no seizure more than 5 years and the frequency of seizures more than 5 times per year before the use of effective drugs was the independent risk factor of recurrence for patients after regular withdraw who with epilepsy. |
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