Discontinuation of antiepileptic therapy in children with complex partial epilepsies
Discontinuation of therapy is always challenging after successful control of epilepsies. Numerous parameters have to be taken in account, and relationship between benefits and any possible damages has to be assessed. The final decision should be made with the parents and the patient. We assessed the role of various factors on the possibility of relapse of epileptic seizures after discontinuation of antiepileptic therapy in patients with complex partial epilepsies. We studied a cohort of children in whom discontinuation of therapy was performed from 20012007. Study included 59 children divided into groups according to age of diagnosis, introduction of antiepileptic therapy, aetiology, neurological and psychological status, results neuroimaging studies, family history, history of febrile seizures, antiepileptic therapy, EEG registration before discontinuation of the treatment, speed of tapering therapy. Multivariable analysis was made, binary logistic regression. Factors that showed statistical significance were: age at the diagnosis, duration of active epilepsy, neurological and psychological status, duration of seizure free period, aetiology, MRI scan and length of tapering the therapy. We conclude that identified factors should be discussed with parents and patients, and to consensus has to be reached.