When should antiepileptic treatment be stopped
When considering stopping an antiepileptic, the risk of seizure recurrence should be weighed against the risk of side effects of continued AED therapy.
Certain seizure types and benign epileptic syndromes may remit. Patients with absence epilepsy often cease having seizures after puberty, and therapy is no longer needed.
Benign childhood epilepsy with centrotemporal spikes also remits. In general, after 2 years of seizure freedom, it is reasonable to consider withdrawing medications.
However, approximately one-third of adult patients and one-fourth of children who are seizure free for 2 years will relapse after termination of antiepileptic medication. Evaluation at this stage typically includes an EEG.
