[Initiation and discontinuation of antiepileptic treatment]

The actual decision regarding whether or not to treat a patient presenting a first seizure must be individualized, considering both the probability of a recurrence, and the perceived risks/benefits ratio of the treatment. The latter depends on the physician's assessment of the potential morbidity of another seizure versus the potential morbidity of antiepileptic drug therapy. In many situations, there is no single correct answer to the question "Should this patient be treated?". The same evaluation of the potential risks and benefit of stopping the treatment arises again when the patient has been seizure-free for a sufficient period of time. The patient must be informed of the pros and cons and should always be associated with the decision.