Drug withdrawal after successful epilepsy surgery: How safe is it?

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 I year 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 I year 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 I lie control group were seizure free 5 years after surgery. In this study, AED discontinuation I year after successful epilepsy Surgery was not associated with a risk of seizure recurrence higher than that of controls. (C) 2009 Elsevier Inc. All rights reserved.