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13.
Drug withdrawal after successful epilepsy surgery : how safe is it?
Kerling, Frank ...
Discontinuation of antiepileptic drugs (AEDs) is one reason patients undergo epilepsy surgery, but little is known about the risk of seizure recurrence. We describe a prospective pilot study of ...withdrawal performed at our epilepsy center. Sixty completely seizure-free patients were included between 1997 and 2003. AED withdrawal was proposed 1year after surgery after a detailed discussion of the risks and benefits. On the basis of their decision on withdrawal, patients were stratified into two cohorts (withdrawal group, N=34;control group, N=26). Discontinuation was carried out in small tapering steps over 1year with yearly follow-up visits. Withdrawal was stopped when seizures recurred or the patients objected to further discontinuation. Twenty-six of 34 (76.5%) persons in the withdrawal group and 16 of 26 (61.5%) persons in the control group were seizure free 5years after surgery. In this study, AED discontinuation 1year after successful epilepsy surgery was not associated with a risk of seizure recurrence higher than that of controls.
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