Risk Factors for Seizure Recurrence After Antiseizure Medication Withdrawal in Children With Childhood Absence Epilepsy

Objective To explore the potential predictive risk factors for seizure recurrence in children with childhood absence epilepsy (CAE) following antiseizure medication withdrawal. Methods A retrospective study was performed on 82 pediatric patients diagnosed with CAE at the Department of Pediatrics, Qilu Hospital of Shandong University. All patients maintained a 2-year seizure-free period after standardized antiseizure treatment and discontinued medication for a minimum of 6 months. Subjects were stratified into a recurrence group and a non-recurrence group according to the presence or absence of recurrent seizures after drug tapering and discontinuation. Univariate analyses, chi-square tests, and binary logistic regression models were applied to identify potential predictive risk factors for seizure recurrence relapse. Results Among the 82 enrolled children with CAE, 17 patients experienced seizure recurrence, corresponding to an overall recurrence rate of 20.73% (17/82). Logistic regression analysis demonstrated that interictal electroencephalogram (EEG) abnormalities, comorbid attention-deficit hyperactivity disorder (ADHD), and EEG abnormalities after medication withdrawal were potential predictive risk factors for seizure recurrence in children with CAE (all P < 0.05). Conclusion Interictal EEG abnormalities, comorbid ADHD, and post-withdrawal EEG abnormalities independently elevate the risk of seizure relapse after medication withdrawal among children with CAE. Clinicians should closely monitor patients presenting these high-risk indicators and establish individualized management protocols at an early stage to reduce the likelihood of seizure recurrence.