Withdrawal of AEDs

Withdrawal should be considered after 2-4 years of remission.

The individual risk/benefit should always be considered and the patient thoroughly informed about the risks of seizure recurrence.

1-7% of patients that experience seizure recurrence after an attempted withdrawal develop treatment-resistant epilepsy.

Favorable factors

• Onset in childhood.
• Generalized genetic epilepsy (not JME).
• BECTS
• Normal EEG.
• Remission and planed pregnancy.
• Comorbidity and drug interaction problems that are aggravated by AED treatment.

Unfavorable factors

• Onset in adolescence or adulthood.
• Focal epilepsy.
• JME
• Structural CNS abnormality causing the seizures.
• Abnormal EEG.
• Need of driver’s license.
• Occupation where seizures carry a high risk for the patient’s safety.