PRESUPPOSTI E CRITERI PER LA SOSPENSIONE DEL TRATTAMENTO CON FARMACI ANTIEPILETTICI

Translated title of the contribution: Criteria for discontinuation of an antiepileptic treatment

G. Avanzini

Research output: Contribution to journalArticlepeer-review

Abstract

In seizure free patients relapse rates after antiepileptic drugs (AEDs) withdrawal are estimated around 40% in adult onset Epilepsies (E) and 20% in infantile E. In a group of clinical forms which account for about one half of the alla E the relapse probability is reliably predicted by the specific E type. This group includes 3 subgroups: 1. partial and generalized idiopatic E with age-dependent remission, in which AEDs can be safely stopped after the active period. 2. Other idiopathic generalized E (typically exemplified by Janz Syndrome) in which the AED stop carries an high relapse risk at any age even after long lasting seizures-free periods. 3. Infantile epileptic encephalopathies with age-dependent expression which can either recover or evolve in other E types: in this case the long term prognosis (and therefore relapse rate after E.AED withdrawal) will be determined by the type of E (typically partial multifocal epilepsies) in which the original form will evolve. The other half of E, consisting mainly of partial symptomatic/cryptogenic forms, is heterogeneous with respect to the prognosis. Relapse risk at the AED discontinuation can be estimated according to the previous course of E. Infantile E with an early onset (within the second year) and delayed (6 years) seizure control have the worst prognosis. More than 1 year delay for seizure control is a bad prognostic factor for adult onset E. Moreover high seizure frequency prior to seizure control carries an higher relapse risk after AED stop. The value of EEG and clinical or radiological evidence of brain damage is debated. Statistical evaluations of these prognostic factors are reported in the following papers.

Translated title of the contributionCriteria for discontinuation of an antiepileptic treatment
Original languageItalian
Pages (from-to)9-13
Number of pages5
JournalBollettino - Lega Italiana contro l'Epilessia
Issue number75-76
Publication statusPublished - 1991

ASJC Scopus subject areas

  • Clinical Neurology

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