PMID- 29248799
OWN - NLM
STAT- MEDLINE
DCOM- 20180806
LR  - 20180806
IS  - 1532-2688 (Electronic)
IS  - 1059-1311 (Linking)
VI  - 54
DP  - 2018 Jan
TI  - Early withdrawal of non-anesthetic antiepileptic drugs after successful 
      termination of nonconvulsive seizures and nonconvulsive status epilepticus.
PG  - 45-50
LID - S1059-1311(17)30383-7 [pii]
LID - 10.1016/j.seizure.2017.12.001 [doi]
AB  - PURPOSE: Multiple antiepileptic drugs (AEDs) are often necessary to treat 
      nonconvulsive seizures (NCS) and nonconvulsive status epilepticus (NCSE). AED 
      polypharmacy places patients at risk for adverse side effects and drug-drug 
      interactions. Identifying the likelihood of seizure relapse when weaning 
      non-anesthetic AEDs may provide guidance in the critical care unit. METHOD: 
      Ninety-nine adult patients with successful treatment of electrographic-proven NCS 
      or NCSE on continuous critical care EEG (CCEEG) monitoring were identified 
      retrospectively. Patients were determined to undergo an AED wean if the number of 
      non-anesthetic AEDs was reduced at the time of discharge compared to the number 
      of non-anesthetic AEDs at primary seizure cessation. Primary outcome was 
      recurrent seizures either clinically or by CCEEG during hospitalization. 
      Secondary outcome measures included hospital length of stay and discharge 
      disposition. RESULTS: The rate of recurrent seizures in the wean group was not 
      statistically different when compared to the group that did not undergo an AED 
      wean (17% vs. 13%, respectively; p = 0.77). The wean group had a median value of 
      4 (IQR: 3-4) non-anesthetic AEDs at the time of primary seizure cessation 
      compared with 3 (IQR: 2-3) in the non-wean group (p < 0.0001). However, both 
      groups had similar values of AEDs at discharge (median of 2 (IQR: 2-3) vs. 3 
      (IQR: 2-3) for wean and non-wean groups respectively; p = 0.40). Discharge 
      disposition (favorable, acceptable, or unfavorable) was similar between groups 
      (p = 0.32). CONCLUSIONS: Early weaning of non-anesthetic AEDs does not increase 
      the risk of recurrent seizures in patients treated for NCS or NCSE during their 
      hospitalization.
CI  - Copyright (c) 2017 British Epilepsy Association. Published by Elsevier Ltd. All 
      rights reserved.
FAU - Creed, Jennifer A
AU  - Creed JA
AD  - Department of Neurology, Duke University Medical Center, Durham, NC, United 
      States.
FAU - Son, Jake
AU  - Son J
AD  - Duke University, School of Engineering, Durham, NC, United States.
FAU - Farjat, Alfredo E
AU  - Farjat AE
AD  - Department of Biostatistics and Bioinformatics, Duke University School of 
      Medicine, United States.
FAU - Swisher, Christa B
AU  - Swisher CB
AD  - Department of Neurology, Duke University Medical Center, Durham, NC, United 
      States.
LA  - eng
PT  - Journal Article
DEP - 20171208
PL  - England
TA  - Seizure
JT  - Seizure
JID - 9306979
RN  - 0 (Anticonvulsants)
SB  - IM
MH  - Aged
MH  - Anticonvulsants/*therapeutic use
MH  - Electroencephalography
MH  - Female
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - Retrospective Studies
MH  - *Safety-Based Drug Withdrawals
MH  - Status Epilepticus/*drug therapy
OTO - NOTNLM
OT  - Antiepileptic drug (AED) withdraw
OT  - Continuous critical care EEG (CCEEG)
OT  - Nonconvulsive seizure (NCS)
OT  - Nonconvulsive status epilepticus (NCSE)
EDAT- 2017/12/19 06:00
MHDA- 2018/08/07 06:00
CRDT- 2017/12/18 06:00
PHST- 2017/06/07 00:00 [received]
PHST- 2017/11/30 00:00 [revised]
PHST- 2017/12/02 00:00 [accepted]
PHST- 2017/12/19 06:00 [pubmed]
PHST- 2018/08/07 06:00 [medline]
PHST- 2017/12/18 06:00 [entrez]
AID - S1059-1311(17)30383-7 [pii]
AID - 10.1016/j.seizure.2017.12.001 [doi]
PST - ppublish
SO  - Seizure. 2018 Jan;54:45-50. doi: 10.1016/j.seizure.2017.12.001. Epub 2017 Dec 8.