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When is it safe to discontinue AED treatment?
Author(s) -
Camfield Peter,
Camfield Carol
Publication year - 2008
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2008.01923.x
Subject(s) - epilepsy , medicine , antiepileptic drug , pediatrics , psychiatry
Summary When people with epilepsy become seizure‐free with daily antiepileptic drug (AED) management, there is a very individual decision to be made about discontinuing this treatment. After 1–6 years of seizure‐freedom, it is estimated that 69% of children and 61% of adults remain seizure‐free when AEDs are tapered and stopped. The length of time that a patient is seizure‐free does not influence the success rate in children but may in adults. The epilepsy syndrome does not seem to influence the chance of success in 75% of children; however, several prediction schemes based on risk factors for recurrence may be useful. There are two major risks in discontinuing treatment—a tiny risk that the epilepsy will not be controlled again and a tiny risk of death during a recurrence. Children who have had 1–2 years seizure‐free deserve a chance to discontinue their AED treatment, whereas in adults this decision probably should wait until there have been at least 4 years of seizure‐freedom.