title: Withdrawal of antiepileptic drugs during presurgical video-EEG monitoring: an observational study for evaluation of current practice at a referral center for epilepsy.
abstract: OBJECTIVE
  Withdrawal of antiepileptic drugs (AEDs) before and during video-EEG-monitoring is commonly implemented to reduce time needed to register a sufficient number of seizures during presurgical evaluation. There are, however, few guidelines regarding withdrawal rate and observation time.
  
  
  METHODS
  We performed an observational study including sixty patients admitted to the national Norwegian epilepsy centre and registered tapering of AEDs and their effect on seizure rate and possible complications.
  
  
  RESULTS
  The mean daily seizure rate before admission to the EMU was 0.4 (range 0.02-4) increasing to 1.1 (range 0-8) at the EMU. 29 patients (48%) followed a slow tapering rate whereas 31 (52%) had an intermediate tapering rate. There was no significant difference between the patients with a daily seizure rate during LTM of more or <0.7 seizures per day, an increase of seizure frequency from habitual to during LTM of more or <3.3 or 6.9 with regard to rate of tapering (slow vs intermediate) etiology or AED monotherapy vs polytherapy. Twenty-six patients (43%) had a sufficient number of seizures registered within 3 days to conclude regarding the presurgical evaluation. Two patients received escape treatment while 25 patients did have 24 h-seizure-clusters. There was no serious event.
  
  
  CONCLUSIONS
  Less than 50% of the patients got a sufficient number of seizures for a conclusive result within 3 days. An increase in the registration period could increase the number of successful registrations.
authors: National Centre for Epilepsy, Oslo University Hospital, Oslo, Norway.
authors: O
authors: O
authors: Henning
authors: A
authors: A
authors: Baftiu
authors: S I
authors: SI
authors: Johannessen
authors: C Johannessen
authors: CJ
authors: Landmark
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome; D014741:Video Recording; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: antiepileptic drugs; drug withdrawal; long-term EEG monitoring; tapering