Withdrawal of antiepileptic treatment — benefits, risks, expediency and safety

May 21, 2020
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Most patients with epilepsy (60–70%), of both childhood and adulthood, can achieve remission of seizures through drug therapy. The subject of discussion for many years is the question of how expedient and safe it can be to stop treatment in a seizure-free patient, under what conditions and in what time frame can be withdrawned anti-epileptic drugs, how quickly doses of drugs should be reduced, what are the risks and benefits of treatment discontinuation, what risk factors exist for relapse of epileptic seizures. An analysis of the available information sources was carried out in order to study the world expertise on this issue. Currently, there is no generally accepted timeline for withdrawal of antiepileptic drugs, as well as clear recommendations for the rate of dose reduction for most anticonvulsants. The article presents the latest literature data on the world expertise of discontinuing antiepileptic therapy in patients of different age groups, with different types of seizures and etiology of epilepsy, describes the main risk factors of treatment withdrawal, options for reducing the dose of antiepileptic drugs, the value of electroencephalography in the process of treatment withdrawal. Own approaches to the discontinuation of antiepileptic therapy are presented.

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