Abstracts

Rationale: To determine: 1) How often seizure-free children have seizure recurrence, 2) Potential risk factors for seizure recurrence, 3) Whether seizure recurrence and intractability occurred more often after anti-epileptic medication (AED) withdrawal. Methods: Records of children age 0-17 years diagnosed with new-onset epilepsy while resident in Olmsted County, Minnesota between 1980-2010 were reviewed. Records of all children treated with AEDs, who became seizure free for more than 1 year and followed >2 years after last seizure were reviewed to determine seizure recurrence and intractability. Potential risk factors for seizure recurrence were assessed, including: AED withdrawal, cognition, neurologic exam, etiology, age of onset, time between diagnosis and seizure freedom, number of AEDs failed due to lack of efficacy, seizure control prior to seizure freedom, history of status epilepticus, and EEG. Results: 308 children fulfilled inclusion criteria, 191 withdrew AEDs. Children with normal cognition (p<0.001), normal exam (p=0.004), and genetic/unknown etiology (p=0.021) were more likely to discontinue AEDs after seizure freedom. Overall, 110 had seizure recurrence. Of these, 63 (20%) were not seizure free at last follow-up. Seizure recurrence was more likely in those with abnormal cognition (p=0.008), epilepsy onset prior to age 1 year (p=0.05), structural/metabolic etiology (p=0.001), >