DISCONTINUATION OF ANTIEPILEPTIC DRUG-TREATMENT AFTER 2 SEIZURE-FREE YEARS IN CHILDREN WITH CEREBRAL-PALSY

Objective. The risk of seizure relapse after antiepileptic drug (AED) discontinuation in children has been reported to vary between 6% and 4 0%. It has been suggested that neurologic deficit and mental retardati on are poor prognostic factors for seizure relapse after AED discontin uation. Because epileptic children with cerebral palsy (CP) have neuro logic deficits, and many have mental retardation, it is important to k now their risk for seizure relapse. Methods. AED treatment was discont inued in 65 children with CP and histories of epilepsy after 2 seizure -free years. All of the patients were followed until they had seizure relapses or for at least 2 years without seizures after AEDs were stop ped. Multiple factors were analyzed for possible association with seiz ure relapse. Results. Twenty-seven patients (41.5%) had seizure relaps es. Patients with spastic hemiparesis had the highest relapse rate (61 .5%), and those with spastic diplegia had the lowest rate (14.3%). No other factor correlated significantly with the risk of seizure relapse . Conclusions. Discontinuation of AEDs in children with CP can, and sh ould, be practiced when possible after patients have been seizure-free for at least 2 years. AED discontinuation in patients with spastic he miparesis is significantly more likely to lead to seizure relapse than in patients with other CP types, but no other factor is yet known to increase the chance of relapse.