Treatment and Discontinuation of Antiepileptic Drugs in Childhood Epilepsy: A Clinical and Electroencephalographic Study

Abstract

The process of discontinuing anticonvulsant medication was studied clinico-electroencephalographically on 285 children with epilepsy. The observation period after discontinuation of anticonvulsants was ranged from two years to 10 years and one month.
The subjects were divided into two groups electroencephalographically: 190 cases in which antiepileptic drugs were formally disconitnued after the complete suppression of epileptic discharge for over two years, and 95 cases in which anticonvulsants were informally discontinued. The relapse rate after discontinuation was significantly lower in the former group, 2.1%, than the latter group, 21.1%. Concerning the seizure-free period, the group of cases free from clinical seizures for over three years by the time of withdrawal showed significantly lower relapse rate than the rest of the cases. Since the relapse of clinical seizures was related to both the snike-free perind and the seizure-free period, the interrelationship between these factors was studied further-more. As the result the spike-free period proved to be a more reliable indirator for stopping medication than the seizure-free period. From these findings, the withdrawal of antiepileptic drugs should be started after suppression of epileptic discharges for over two years in childhood epilepsy.
However, since each epileptic patient is based on different pathophysiology and etiology, the discontinuation of antiepileptic drugs should be determined not only electroencephalographically, but also taking various clinical factors into consideration comprehensively.