title: Risk factors for recurrence of epilepsy and withdrawal of antiepileptic therapy: a practical approach.
abstract: In epileptic patients, treated with anticonvulsant drugs (AEDs), the question when and how an attempt should be made to withdraw therapy is a crucial point in the management of these patients. In recent years, many studies have identified the main risk factors for seizure recurrence after discontinuation of AEDs. Patients are more likely to have recurrences if there is a definite symptomatic aetiology, two or more different types of seizures, an abnormal neurological examination and a seizure onset at adolescence or later. In contrast, abnormal EEG has not been proved as a risk factor for recurrence. Moreover, the classification of epilepsy syndromes is another important predictor of the outcome for these patients. In practice, most authors suggest that medication is discontinued after a seizure-free period of two years. In this review we analyse data from the literature and we suggest a practical approach for safe anticonvulsant withdrawal, although the decision should always be made individually, weighing risks and benefits.
authors.affiliation: Department of Medicine, Section of Pediatrics, University of Chieti-Ospedale Policlinico, Italy. averrott@obelix.unich.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Verrotti
authors.forename: Daniela
authors.initials: D
authors.lastname: Trotta
authors.forename: Carmela
authors.initials: C
authors.lastname: Salladini
authors.forename: Guido
authors.initials: G
authors.lastname: Morgese
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarelli
mesh_terms: D017668:Age of Onset; D000927:Anticonvulsants / Q000009:adverse effects*; D002648:Child; D004334:Drug Administration Schedule; D004569:Electroencephalography; D004827:Epilepsy / Q000139:chemically induced* / Q000145:classification / Q000175:diagnosis / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors; D013375:Substance Withdrawal Syndrome
chemical_list: D000927:Anticonvulsants