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Reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment
PURPOSE: We aimed to analyze the potential for postoperative (PO) medication suspension and reduction, emphasizing passive withdrawal. METHODS: Retrospective study of patients under 18 years old submitted to surgical treatment for pharmacoresistant epilepsy and classified as Engel I during the first...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9798357/ https://www.ncbi.nlm.nih.gov/pubmed/36580119 http://dx.doi.org/10.1007/s00381-022-05812-0 |
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author | de Matos, Maiave Micaelle Figueiredo Batista, Larissa Aparecida Thomé, Ursula Sakamoto, Américo Ceiki Santos, Marcelo Volpon Machado, Hélio Rubens Wichert-Ana, Lauro Hamad, Ana Paula Andrade |
author_facet | de Matos, Maiave Micaelle Figueiredo Batista, Larissa Aparecida Thomé, Ursula Sakamoto, Américo Ceiki Santos, Marcelo Volpon Machado, Hélio Rubens Wichert-Ana, Lauro Hamad, Ana Paula Andrade |
author_sort | de Matos, Maiave Micaelle Figueiredo |
collection | PubMed |
description | PURPOSE: We aimed to analyze the potential for postoperative (PO) medication suspension and reduction, emphasizing passive withdrawal. METHODS: Retrospective study of patients under 18 years old submitted to surgical treatment for pharmacoresistant epilepsy and classified as Engel I during the first year of PO follow-up. Therapeutic management was evaluated through discontinuation or reduction of medications, both in terms of the number of ASM prescribed and in daily maintenance dosages in mg/kg. RESULTS: ASM withdrawal started in the first year PO and occurred in 1.2% of cases, with a significant yearly reduction in the number of ASM during follow-up (p < 0.001). A comparison of the most commonly used ASM in daily mg/kg between the preoperative period (preop) and PO showed a reduction of ASM maintenance dosages during PO. Even though recurrence of seizures was observed 5 years after surgery, 125 patients (85%) were still classified as Engel I, albeit a higher number of ASM per patient was observed. Most patients showed no changes in cognitive and adaptive behavior evaluation between preop and PO, even in those who were able to reduce ASM. CONCLUSION: Significant reduction observed both in the number and daily maintenance dosages of ASM following each year of PO may be an indirect measure of the effectiveness of epilepsy surgery. |
format | Online Article Text |
id | pubmed-9798357 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-97983572022-12-29 Reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment de Matos, Maiave Micaelle Figueiredo Batista, Larissa Aparecida Thomé, Ursula Sakamoto, Américo Ceiki Santos, Marcelo Volpon Machado, Hélio Rubens Wichert-Ana, Lauro Hamad, Ana Paula Andrade Childs Nerv Syst Original Article PURPOSE: We aimed to analyze the potential for postoperative (PO) medication suspension and reduction, emphasizing passive withdrawal. METHODS: Retrospective study of patients under 18 years old submitted to surgical treatment for pharmacoresistant epilepsy and classified as Engel I during the first year of PO follow-up. Therapeutic management was evaluated through discontinuation or reduction of medications, both in terms of the number of ASM prescribed and in daily maintenance dosages in mg/kg. RESULTS: ASM withdrawal started in the first year PO and occurred in 1.2% of cases, with a significant yearly reduction in the number of ASM during follow-up (p < 0.001). A comparison of the most commonly used ASM in daily mg/kg between the preoperative period (preop) and PO showed a reduction of ASM maintenance dosages during PO. Even though recurrence of seizures was observed 5 years after surgery, 125 patients (85%) were still classified as Engel I, albeit a higher number of ASM per patient was observed. Most patients showed no changes in cognitive and adaptive behavior evaluation between preop and PO, even in those who were able to reduce ASM. CONCLUSION: Significant reduction observed both in the number and daily maintenance dosages of ASM following each year of PO may be an indirect measure of the effectiveness of epilepsy surgery. Springer Berlin Heidelberg 2022-12-29 2023 /pmc/articles/PMC9798357/ /pubmed/36580119 http://dx.doi.org/10.1007/s00381-022-05812-0 Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Original Article de Matos, Maiave Micaelle Figueiredo Batista, Larissa Aparecida Thomé, Ursula Sakamoto, Américo Ceiki Santos, Marcelo Volpon Machado, Hélio Rubens Wichert-Ana, Lauro Hamad, Ana Paula Andrade Reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment |
title | Reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment |
title_full | Reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment |
title_fullStr | Reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment |
title_full_unstemmed | Reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment |
title_short | Reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment |
title_sort | reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9798357/ https://www.ncbi.nlm.nih.gov/pubmed/36580119 http://dx.doi.org/10.1007/s00381-022-05812-0 |
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