Sospensione della terapia antiepilettica nell'adulto: Analisi retrospettiva di una casistica di 125 pazienti

AED withdrawal (AEDW) is still a difficult choice; literature data showed extreme variability in relapse frequency, ranging between 12 and 67%. We reviewed the records of 125 subjects that withdraw the therapy; minimum follow-up was 6 months. 57.6% patients were affected by generalized and 42.4% by partial epilepsy. 57 patients relapsed: the overall frequency was 45.6%. Etiology was idiopathic in 45% of patients, cryptogenic in 41.6%, and lesional in 12.8%; relapses were observed in 35% of idiopathic, in 53.8% of cryptogenic and in 50% of lesional patients. Time of relapse was within a month in 28% of patients, within 1 year in 66.5% and more than 1 year in 33.5%. No relations were observed between AED and risk of relapse (RR), as well as between duration of free interval, beginning of AEDW and RR. Relapses were characterized by major seizures in 66.6% of patients, and by minor seizures in 33.4%. AEDW should be started in patients with low RR after extensive presentation of risks.