Stopping antiepileptic therapy in mentally-retarded, epileptic children

It has, increasingly, become the practice to withdraw antiepileptic drugs (AEDs) in epileptic patients, who have been seizure-free for two years. However, the presence of mental retardation is frequently considered to be a markedly adverse factor for stopping treatment. Many physicians are loth to phase out AEDs in mentally retarded patients. In this study, 29 well-controlled epileptic, mentally-retarded children had their AEDs withdrawn. Seventeen have remained well and 12 have relapsed. IQ, neurological findings, EEGs, types of epilepsy, frequency of attacks, age of onset, duration of the active disease and the fit-free period, and antiepileptic drug (AED) levels did not predict the outcome. It is suggested that consideration be given to withdrawing AEDs from well-controlled, mentally-retarded, epileptic children.