28% recurrence rate after antiseizure medication withdrawal in children with epilepsyStopping seizure meds in children: 28% recurrence risk

This meta-analysis pooled data from 3,226 children with epilepsy to estimate the recurrence rate after antiseizure medication withdrawal. The overall pooled recurrence rate was 28% (95% CI: 23%–33%). Several risk factors were identified that increase the likelihood of seizure recurrence, including female gender, focal seizure type, history of febrile seizures, delayed development or intellectual disability, symptomatic etiology, and abnormal electroencephalogram (EEG) after withdrawal.

The analysis did not report on specific adverse events, serious adverse events, or discontinuations related to withdrawal. Limitations of the meta-analysis were not reported in the source, and the certainty of the evidence was not assessed. The authors emphasize that multiple factors contribute to recurrence risk, supporting the need for individualized clinical decision-making when considering medication withdrawal.

For clinicians, these findings highlight the importance of evaluating individual risk factors before discontinuing antiseizure medications in children. The 28% recurrence rate provides a benchmark for counseling families, though the absence of reported limitations and certainty assessment warrants cautious interpretation.