[Discontinuing anticonvulsant therapy: anthropologic aspects]

The ultimate aim of a successful treatment of epilepsy is freedom from seizures, even after the discontinuation of medicinal treatment. Relapses can however not be excluded even under a favorable course of the disease. In the event of a good medical prognosis in respect of relapses, a recurrence of seizure can lead to a severe threat in the sphere of social and personal life of the individual. On the basis of specimen examples such situations in life are presented, wherein relapse of seizures resulted in serious psycho-social problems. From the unstable periods of life, special emphasis is placed on the second "social" phase of puberty. The complexity of situation in this period of life, together with its closely following transitory phases of one social structure into another (school, professional training, career) demands caution in planning the discontinuation of therapy, as relapses may lead to disturbing consequences on further plans of life. This applies even more to professional part of life, threatening the stability of employment with frequent change of jobs, resulting in a vulnerable area. The consequences of relapses can lead to regression of professional progress, the loss of external existence and lack of one's own self confidence. The significance of fear and anxiety as marked factors contributing for relapses will be emphasized. More over it is important to consider carefully the pathogenic family structure, in which relapse can break out concealed fears and rejections leading to serious disturbances in the private life of the subject. The discontinuation of antiepileptic medication under suitable circumstances is not basically disagreed upon.(ABSTRACT TRUNCATED AT 250 WORDS)