Recurrence rate, risk factors for recurrence, and outcome in 161 children after early withdrawal of antiepileptic drugs (AEDs) were studied at Leiden University and other centers in The Netherlands. The probability of remaining seizure free at 24 months was 51% for 78 patients whose AEDs were discontinued after a 6 month seizure-free period, and 52% for 83 patients with a 12 month period of seizure control. Risk factors for relapse were partial epilepsy, onset of seizures at 12 years or older, known seizure etiology, and epileptiform EEG. After a mean 42 month follow-up, 129 (80%) were seizure free for at least 1 year, two thirds without AEDs. [1]

COMMENT. Early withdrawal of antiepileptic therapy after 6 or 12 months seizure control is followed by seizure recurrence in 50% of patients, regardless of the treatment duration. A comparison of these results of early drug withdrawal with previous reports of later withdrawal (2, 3, or 4 years) suggests an optimal seizure-free treatment period of 2 years. The shorter duration of seizure-free therapy results in a higher relapse rate. (See Progress in Pediatric Neurology III, 1997;pp115-122).