Interruption of antiepileptic therapy in seizure-free patients following surgery to remove the epileptogenic lesion
Sironi, V.A.; Ravagnati, L.; Ettorre, G.; Marossero, F.
Rivista di Neurologia 53(4): 247-256
1983
ISSN/ISBN: 0035-6344 PMID: 6415803 Document Number: 221089
This paper presents a series of 20 epileptic patients operated on at our Institute, with a clinical, EEG and drug plasma level follow-up, for periods from 48 to 60 months. Following surgery a group of 12 patients were seizure-free in a 3 year period of follow-up, and anticonvulsant medication was gradually withdrawn. While in 8 of these patients drug interruption uneventful, in 4 cases drug withdrawal caused the seizure to reappear. These 4 patients became seizure-free again, following a reintroduction of pharmacological therapy, which appeared to be effective also at low doses. Another group of 8 patients continued to have seizure also after surgery. Following quantitative and qualitative adjustments of their anticonvulsant medication, 5 patients became again seizure-free, while 3 continued to have seizures. Our experience suggests that in patients in whom the epileptogenic lesions have been surgically removed, anticonvulsant therapy can be safely withdrawn and removed after a seizure-free period of 3 years. Reappearance of seizures after drug withdrawal has a good prognosis, since a simple readjustment of medical therapy is usually effective in preventing further seizures to occur.