Suppression of antiepileptic treatment

The present report evaluates the suppression of antiepileptic drugs in a group of 608 epileptics. Conditions for the suppression of antiepileptic treatment included a previous seizure-free period of 5 years under medication, and a careful evaluation of individual social and work-related circumstances. The reduction of medication was realized during a minimum period of 1 year, passing from eventual polytherapy to monotherapy. Of the total 608 epileptics in whom treatment was suppressed, 144 relapses (23.7%) occurred, and 464 (76.3%) patients continued to be seizure-free. A complete remission of the epilepsy was achieved in 14.3% of 3,254 epileptics with an adequate follow-up. Significant risk factors for recurrence included a delay in starting anticonvulsant therapy; symptomatic generalized epilepsy; different types of combined seizures, or atypical absences and/or tonic crisis and/or atonic crisis; or partial complex associated with secondary generalized tonic-clonic seizures; the presence of status epilepticus in the course of the disease and permanent neurologic damage. With the patient's prior agreement, it was possible to suppress anticonvulsant medication in one fourth of nonselected epileptic patients with a possibility of relapse in about 25% of the cases (generally one isolated seizure).