Abstract
To evaluate the risk of relapse in children with epilepsy or febrile convulsion whose chronic anticonvulsant therapy has been withdrawn after prolonged control, we studied 115 such children for more than 2 years or until relapse. Anticonvulsant therapy was discontinued in 77 children with epilepsy (51 cases with generalized tonic clonic seizure, cases with Sylvian seizure, 4 cases with other partial seizure, 3 cases with absence seizure) whose seizures had been easily controlled by treatment and who had had no seizures for 2 or more years, and in 38 children with febrile convulsion who had had seizures for 1 or more years and had reached more than 4 years of age. Medication was gradually withdrawn over six to twelve months. The 77 patients with epilepsy and 38 patients with febrile convulsion ranged in age from 4 to 23 years and from 4 to years respectively when their medications were discontinued. Only five (4%) of 115 patients had a recurrence of seizures. Seizure recurred in 2 patients with generalized tonic clonic seizure and in 3 patients with febrile convulsion. These seizures recurred at from 4 months to 2 years and 8 months (mean 1 year and 7 months) after discontinuation of therapy.
In 44 patients (23 cases with epilepsy and 21 cases with febrile convulsion) epileptiform EEG activities were found at time of withdrawal of therapy and/or after drug withdrawal. We found that abnormal electroencephalographic tracings did not contraindicate slow elimination of medication in children who had not had seizures for many years.
