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 y...
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| Veröffentlicht in: | Child's nervous system 2023-05, Vol.39 (5), p.1193-1200 |
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| creator | 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 |
| 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
|
| doi_str_mv | 10.1007/s00381-022-05812-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9798357</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2759266371</sourcerecordid><originalsourceid>FETCH-LOGICAL-c397t-f88426b20f5230726fa727ca2b6e7ae8a5cad5fc62fa77ffa3b7510c91a8db8f3</originalsourceid><addsrcrecordid>eNp9kU9v1DAQxS0EotvCF-CAfOSSMrbXsXNBQhX_pEpIFT1bjjPedZXEwXZA5cJXx9stFVx6seV5b34z8iPkFYNzBqDeZgChWQOcNyA1q-cTsmFbIRoQEp6SDXDZNgq2cEJOc74BYFLz7jk5Ea3UwFi3Ib-vcFhdCXGmYaZ2LqHJGH6tCemEQ3D2IGW6ZjzoSy3ZkoKjSxVwLpn-DGVPl71Nk3UxYQ65VArFJYy45Fua134KpeBAS6yPtKvMkZaEtkwV8II883bM-PL-PiPXHz98u_jcXH799OXi_WXjRKdK47Xe8rbn4CUXoHjrreLKWd63qCxqK50dpHctr4Ly3opeSQauY1YPvfbijLw7cpe6Dw6ujk52NEsKk023Jtpg_lfmsDe7-MN0qtNCqgp4cw9I8fuKuZgpZIfjaGeMazZcyY63rVCsWvnR6lLMOaF_GMPAHJIzx-RMTc7cJWegNr3-d8GHlr9RVYM4GnKV5h0mcxPXNNdPewz7Bytwqcs</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2759266371</pqid></control><display><type>article</type><title>Reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>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</creator><creatorcontrib>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</creatorcontrib><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.</description><identifier>ISSN: 0256-7040</identifier><identifier>EISSN: 1433-0350</identifier><identifier>DOI: 10.1007/s00381-022-05812-0</identifier><identifier>PMID: 36580119</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Anticonvulsants - adverse effects ; Anticonvulsants - therapeutic use ; Child ; Epilepsy - drug therapy ; Epilepsy - surgery ; Humans ; Medicine ; Medicine & Public Health ; Neurosciences ; Neurosurgery ; Neurosurgical Procedures ; Original ; Original Article ; Retrospective Studies ; Treatment Outcome</subject><ispartof>Child's nervous system, 2023-05, Vol.39 (5), p.1193-1200</ispartof><rights>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.</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>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.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c397t-f88426b20f5230726fa727ca2b6e7ae8a5cad5fc62fa77ffa3b7510c91a8db8f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00381-022-05812-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00381-022-05812-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36580119$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Matos, Maiave Micaelle Figueiredo</creatorcontrib><creatorcontrib>Batista, Larissa Aparecida</creatorcontrib><creatorcontrib>Thomé, Ursula</creatorcontrib><creatorcontrib>Sakamoto, Américo Ceiki</creatorcontrib><creatorcontrib>Santos, Marcelo Volpon</creatorcontrib><creatorcontrib>Machado, Hélio Rubens</creatorcontrib><creatorcontrib>Wichert-Ana, Lauro</creatorcontrib><creatorcontrib>Hamad, Ana Paula Andrade</creatorcontrib><title>Reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment</title><title>Child's nervous system</title><addtitle>Childs Nerv Syst</addtitle><addtitle>Childs Nerv Syst</addtitle><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.</description><subject>Adolescent</subject><subject>Anticonvulsants - adverse effects</subject><subject>Anticonvulsants - therapeutic use</subject><subject>Child</subject><subject>Epilepsy - drug therapy</subject><subject>Epilepsy - surgery</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Neurosurgical Procedures</subject><subject>Original</subject><subject>Original Article</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0256-7040</issn><issn>1433-0350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9v1DAQxS0EotvCF-CAfOSSMrbXsXNBQhX_pEpIFT1bjjPedZXEwXZA5cJXx9stFVx6seV5b34z8iPkFYNzBqDeZgChWQOcNyA1q-cTsmFbIRoQEp6SDXDZNgq2cEJOc74BYFLz7jk5Ea3UwFi3Ib-vcFhdCXGmYaZ2LqHJGH6tCemEQ3D2IGW6ZjzoSy3ZkoKjSxVwLpn-DGVPl71Nk3UxYQ65VArFJYy45Fua134KpeBAS6yPtKvMkZaEtkwV8II883bM-PL-PiPXHz98u_jcXH799OXi_WXjRKdK47Xe8rbn4CUXoHjrreLKWd63qCxqK50dpHctr4Ly3opeSQauY1YPvfbijLw7cpe6Dw6ujk52NEsKk023Jtpg_lfmsDe7-MN0qtNCqgp4cw9I8fuKuZgpZIfjaGeMazZcyY63rVCsWvnR6lLMOaF_GMPAHJIzx-RMTc7cJWegNr3-d8GHlr9RVYM4GnKV5h0mcxPXNNdPewz7Bytwqcs</recordid><startdate>20230501</startdate><enddate>20230501</enddate><creator>de Matos, Maiave Micaelle Figueiredo</creator><creator>Batista, Larissa Aparecida</creator><creator>Thomé, Ursula</creator><creator>Sakamoto, Américo Ceiki</creator><creator>Santos, Marcelo Volpon</creator><creator>Machado, Hélio Rubens</creator><creator>Wichert-Ana, Lauro</creator><creator>Hamad, Ana Paula Andrade</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230501</creationdate><title>Reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment</title><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></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c397t-f88426b20f5230726fa727ca2b6e7ae8a5cad5fc62fa77ffa3b7510c91a8db8f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adolescent</topic><topic>Anticonvulsants - adverse effects</topic><topic>Anticonvulsants - therapeutic use</topic><topic>Child</topic><topic>Epilepsy - drug therapy</topic><topic>Epilepsy - surgery</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Neurosurgical Procedures</topic><topic>Original</topic><topic>Original Article</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Matos, Maiave Micaelle Figueiredo</creatorcontrib><creatorcontrib>Batista, Larissa Aparecida</creatorcontrib><creatorcontrib>Thomé, Ursula</creatorcontrib><creatorcontrib>Sakamoto, Américo Ceiki</creatorcontrib><creatorcontrib>Santos, Marcelo Volpon</creatorcontrib><creatorcontrib>Machado, Hélio Rubens</creatorcontrib><creatorcontrib>Wichert-Ana, Lauro</creatorcontrib><creatorcontrib>Hamad, Ana Paula Andrade</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Child's nervous system</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Matos, Maiave Micaelle Figueiredo</au><au>Batista, Larissa Aparecida</au><au>Thomé, Ursula</au><au>Sakamoto, Américo Ceiki</au><au>Santos, Marcelo Volpon</au><au>Machado, Hélio Rubens</au><au>Wichert-Ana, Lauro</au><au>Hamad, Ana Paula Andrade</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment</atitle><jtitle>Child's nervous system</jtitle><stitle>Childs Nerv Syst</stitle><addtitle>Childs Nerv Syst</addtitle><date>2023-05-01</date><risdate>2023</risdate><volume>39</volume><issue>5</issue><spage>1193</spage><epage>1200</epage><pages>1193-1200</pages><issn>0256-7040</issn><eissn>1433-0350</eissn><abstract>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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36580119</pmid><doi>10.1007/s00381-022-05812-0</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Anticonvulsants - adverse effects Anticonvulsants - therapeutic use Child Epilepsy - drug therapy Epilepsy - surgery Humans Medicine Medicine & Public Health Neurosciences Neurosurgery Neurosurgical Procedures Original Original Article Retrospective Studies Treatment Outcome |
| title | Reduction in anti-seizure medications use in pediatric patients with pharmacoresistant epilepsy submitted to surgical treatment |
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