Recurrence rate and risk factors of recurrence after antiseizure medications withdrawal in children with epilepsy: a meta-analysis.

OBJECTIVE: This study aims to explore the recurrence rate and risk factors for recurrence after antiseizure medications withdrawal in children with epilepsy through a meta-analysis. METHODS: Databases were searched up to May 8, 2025. Two reviewers independently screened the literature, extracted data, and assessed study quality. A meta-analysis was performed using Stata 15.0. RESULTS: Nineteen studies involving 3,226 children were included. The pooled recurrence rate was 28% (95% CI: 23%-33%). Risk factors included female gender, focal seizure, history of febrile seizures, delayed development/intellectual disability, symptomatic etiology, abnormal electroencephalogram (EEG) after withdrawal. CONCLUSION: Multiple factors increase recurrence risk after antiseizure medications withdrawal in children, supporting individualized clinical decision-making.