Analysis Of Risk Factors For Recurrence Of Idiopathic Generalized Epilepsy After Drug Withdrawal

Objectives To observe the recurrence of patients with idiopathic generalized epilepsy within one year after the end of antiepileptic drug treatment,and to analyze the risk factors and induced factors of recurrence after the end of the treatment.To provide evidence for the clinical work of withdrawal antiepileptic drugs for idiopathic comprehensive epilepsy.Methods The clinical data of 96 patients with IGE diagnosed in the epilepsy clinic of the First Affiliated Hospital of Anhui Medical University from January 2016 to January 2019 were analyzed retrospectively.All patients were treated with AEDs and stopped taking AEDs.Among them,40 patients relapsed(relapse group)and 56 patients did not(control group)during one year's follow-up.Information of all the patients in both groups were recorded,including age,history of febrile seizures(FS),family history of epilepsy,history of status epilepticus(SE),the number of attacks per year(attack frequency)between the treatment of AEDs and the last attack,the time from the beginning of withdrawal to the complete withdrawal(withdrawal speed),the first electroencephalogram(EEG),the electroencephalogram performance after withdrawal,the number of AEDs drugs and other related factors,infection status,fatigue,menstruation,pregnancy and other behavior indicators(drinking coffee/tea/coke,drinking alcohol,Sleep deficiency,staying up late,taking antibiotics orally,watching TV/mobile phone/ computer),Single factor analysis and logistic multiple regression were used to analyze the related factors.Results Among 96 patients,40(41.7%)had relapse within one year,56(58.3%)had no relapse.The results showed that female(P < 0.05),abnormal EEG for the first time(P < 0.05),abnormal EEG after discontinuation(P < 0.05),seizure frequency > 5 time / years(P <0.05),withdrawal time?6 months(P < 0.05),combined medication(P < 0.05)were related to higher recurrence risk after discontinuation of IGE.There were no correlation between the onset age,history of febrile seizures,history of status epilepticus,family history of epilepsy and recurrence of IGE after discontinuation.Logistic multiple regression analysis showed that female(OR=3.550,P=0.024),abnormal EEG for the first time(OR=4.532,P=0.015),abnormal EEG after discontinuation(OR=4.233,P=0.012),seizure frequency > 5 time / years(OR=5.431,P=0.007),withdrawal time ?6months(OR=7.378,P=0.001),combined medication(OR=4.966,P=0.007)were independent risk factors for relapse.Among 40 cases of recurrence,25 cases(62.5%)with inducement and 15 cases(37.5%)without inducement.Drinking 2 cases(8.0% in relapse),caffeine 4 cases(16.0%),sleep disorder 4 cases(16.0%),oral antibiotics 3 cases(12.0%),infection 3 cases(12.0%),watching TV,mobile phone,computer 5 cases(20%),learning pressure 1 case(4%)Fatigue in 1 case(4%),menstruation in 1 case(4%),pregnancy in 1 case(4%).Conclusions Risk factors for the recurrence of IGE patients after discontinuation including female,abnormal EEG for the first time,abnormal EEG after discontinuation,attack frequency > 5 time / years,withdrawal time ? 6 months,and combined medication.Especially,female,abnormal EEG for the first time,abnormal EEG after discontinuation,attack frequency > 5 time / years,withdrawal time ? 6 months,combined medication were independent risk factors of recurrence after IGE discontinuation.In addition,drinking coffee/tea/cola,drinking alcohol,lack of sleep,staying up late,oral antibiotics,infection,watching TV/mobile phone/computer,learning pressure,fatigue,menstruation,and pregnancy can induce recurrence.Therefore,we should identify the risk factors and inducing factors of patients with IGE in the early stage,to reduce the recurrence rate of patients with IGE after stopping treatment.