[Interruption of antiepileptic therapy in seizure-free patients following surgery to remove the epileptogenic lesion].
This paper presents a series of 20 epileptic patients operated on at our Institute, with a clinical, EEG and drug plasma level follow-up, for periods from 48 to 60 months. Following surgery a group of 12 patients were seizure-free in a 3 year period of follow-up, and anticonvulsant medication was gradually withdrawn. While in 8 of these patients drug interruption uneventful, in 4 cases drug withdrawal caused the seizure to reappear. These 4 patients became seizure-free again, following a reintroduction of pharmacological therapy, which appeared to be effective also at low doses. Another group of 8 patients continued to have seizure also after surgery. Following quantitative and qualitative adjustments of their anticonvulsant medication, 5 patients became again seizure-free, while 3 continued to have seizures. Our experience suggests that in patients in whom the epileptogenic lesions have been surgically removed, anticonvulsant therapy can be safely withdrawn and removed after a seizure-free period of 3 years. Reappearance of seizures after drug withdrawal has a good prognosis, since a simple readjustment of medical therapy is usually effective in preventing further seizures to occur.
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage*; D002220:Carbamazepine / Q000008:administration & dosage; D002648:Child; D002998:Clonazepam / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010634:Phenobarbital / Q000008:administration & dosage; D010672:Phenytoin / Q000008:administration & dosage; D011182:Postoperative Care
D000927:Anticonvulsants; D002220:Carbamazepine; D002998:Clonazepam; D010672:Phenytoin; D010634:Phenobarbital
Interruzione della terapia antiepilettica nei pazienti liberi da crisi dopo intervento per la rimozione della lesione epilettogena.