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Abstract：
We aimed to analyze the potential for postoperative (PO) medication suspension and reduction, emphasizing passive withdrawal.
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.
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.
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.
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.
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.
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.
摘要：
目的：我们旨在分析术后（PO）药物暂停和减少的可能性，强调被动退出。
方法：回顾性研究18岁以下接受药物耐药性癫痫手术治疗的患者，在PO随访的第一年被归类为EngelI。通过停药或减少药物来评估治疗管理，就处方ASM的数量和每日维持剂量（mg/kg）而言。
结果：ASM退出始于PO的第一年，发生在1.2％的病例中，随访期间ASM数量每年显著减少(p<0.001)。在术前（术前）和PO之间最常用的每日mg/kgASM的比较显示，PO期间ASM维持剂量减少。即使在手术后5年观察到癫痫复发，125例患者(85%)仍被归类为EngelI，尽管观察到每位患者的ASM数量较高。大多数患者在术前和PO之间的认知和适应行为评估没有变化，即使是那些能够减少ASM的人。
结论：每年PO后，ASM的数量和每日维持剂量均显著减少，这可能是癫痫手术有效性的间接测量指标。
方法：回顾性研究18岁以下接受药物耐药性癫痫手术治疗的患者，在PO随访的第一年被归类为EngelI。通过停药或减少药物来评估治疗管理，就处方ASM的数量和每日维持剂量（mg/kg）而言。
结果：ASM退出始于PO的第一年，发生在1.2％的病例中，随访期间ASM数量每年显著减少(p<0.001)。在术前（术前）和PO之间最常用的每日mg/kgASM的比较显示，PO期间ASM维持剂量减少。即使在手术后5年观察到癫痫复发，125例患者(85%)仍被归类为EngelI，尽管观察到每位患者的ASM数量较高。大多数患者在术前和PO之间的认知和适应行为评估没有变化，即使是那些能够减少ASM的人。
结论：每年PO后，ASM的数量和每日维持剂量均显著减少，这可能是癫痫手术有效性的间接测量指标。
