WITHDRAWAL OF ANTIEPILEPTIC DRUG-TREATMENT IN CHILDHOOD EPILEPSY - FACTORS RELATED TO AGE

The clinical and electroencephalographic changes with age were evaluat ed in 304 patients with childhood epilepsies, whose antiepileptic trea tment had been discontinued after a seizure free period of more than t hree years. The withdrawal rate differed significantly between epilept ic syndromes, being higher in idiopathic and lower in symptomatic epil epsy. The age at withdrawal was characteristic for each epileptic synd rome, and generally showed two peaks: at preadolescence and early scho ol age. Forty one (13.5%) of the 304 patients experienced relapses. Th e relapse rate differed between epileptic syndromes. Relapses occurred at a unique age in each epileptic syndrome, and were frequent in prea dolescence and early adulthood. Electroencephalography that still show ed paroxysmal discharges at withdrawal did not necessarily predict the occurrence of a relapse, but the changes in background activity with age, which may indicate maturation of the CNS, were significantly diff erent between the patients with and those without relapses. The result s suggest that age related to each epileptic syndrome should be consid ered when deciding on withdrawal of antiepileptic drugs.