Currently, there is a limited availability of tools to predict seizure recurrence after discontinuation of antiseizure medications (ASMs). This study aimed to establish the seizure recurrence rate following ASM cessation in adult patients with idiopathic generalized epilepsy (IGE) and to assess the predictive performance of the Lamberink and the Stevelink prediction models using real-world data. Retrospective longitudinal study in IGE patients who underwent ASM withdrawal in a tertiary epilepsy clinic since June 2011, with the latest follow up in January 2024. The minimum follow-up period was 12 months. Clinical and demographic variables were collected, and the seizure recurrence prediction models proposed by Lamberink and Stevelink were applied and evaluated. Forty-seven patients (mean age 33.15 ± 8 [20–55] years; 72.35 % women) were included. During the follow-up period, seizures recurred in 25 patients (53.2 %). Median time to recurrence was 8 months [IQR 3–13.5 months], and 17 patients (68 %) relapsed within the first year. None of the relapsing patients developed drug-resistant epilepsy. The only significant risk factor associated with recurrence was a seizure-free period of less than 2 years before discontinuing medication (91.7 % vs 40 %, p =.005). The Stevelink prediction model at both 2 (p =.015) and 5 years (p =.020) achieved statistical significance, with an AUC of 0.72 (95 % CI 0.56–0.88), while the Lamberink model showed inadequate prognostic capability. In our real-world cohort, a seizure-free period of at least 2 years was the only factor significantly associated with epilepsy remission after ASM withdrawal. Larger studies are needed to accurately predict seizure recurrence in IGE patients.

中文翻译：

---

成人特发性全身性癫痫患者的抗癫痫药物戒断：两种癫痫复发预测模型的表现

目前，用于预测停用抗癫痫药物 (ASM) 后癫痫发作复发的工具有限。本研究旨在确定成年特发性全身性癫痫 (IGE) 患者停止 ASM 后的癫痫复发率，并使用真实世界数据评估 Lamberink 和 Stevelink 预测模型的预测性能。对自2011年6月起在三级癫痫诊所接受ASM戒断的IGE患者进行回顾性纵向研究，最近一次随访时间为2024年1月。最短随访时间为12个月。收集临床和人口统计学变量，并应用和评估 Lamberink 和 Stevelink 提出的癫痫复发预测模型。纳入 47 名患者（平均年龄 33.15 ± 8 [20-55] 岁；72.35% 为女性）。随访期间，25 名患者（53.2%）再次出现癫痫发作。中位复发时间为 8 个月 [IQR 3-13.5 个月]，17 名患者 (68%) 在第一年内复发。没有一位复发患者出现耐药性癫痫。与复发相关的唯一显着风险因素是停药前不到 2 年的无癫痫发作期（91.7 % vs 40 %，p = 0.005）。 Stevelink 预测模型在 2 年 (p = 0.015) 和 5 年 (p = 0.020) 时均取得了统计显着性，AUC 为 0.72 (95% CI 0.56–0.88)，而 Lamberink 模型的预测能力不足。在我们的现实队列中，至少 2 年的无癫痫发作期是与 ASM 停药后癫痫缓解显着相关的唯一因素。需要更大规模的研究来准确预测 IGE 患者的癫痫复发。