Timing of antiepileptic drug withdrawal and long-term seizure outcome after paediatric epilepsy surgery (TimeToStop): a retrospective observational study

Early withdrawal of non-anesthetic antiepileptic drugs after successful termination of nonconvulsive seizures and nonconvulsive status epilepticus

“…In a survey administered to 204 adult and pediatric epileptologists, Swisher and colleagues found that most epileptologists tapered AEDs more rapidly than suggested by previous reports with the majority stopping all AEDs completely following epilepsy surgery [23]. Additionally the European TimeToStop observational study found that early AED withdrawal did not affect long-term seizure outcome [40]. In the TimeToStop study, primidone, vigabatrin and phenytoin were most frequently reduced first.…”

Survey of current practices among US epileptologists of antiepileptic drug withdrawal after epilepsy surgery

“…On the other hand, a study by Schiller et al supports the practice of an early AED taper and found that seizure recurrence after AED withdrawal was unrelated to the duration of the seizure-free period after surgery [6]. In the European TimeToStop observational study that included 766 children, the median time for initiation of AED taper was 12.5 months, suggesting that American and Canadian epileptologists begin AED tapering earlier than their European colleagues [11]. More importantly, the TimeToStop study found that early AED withdrawal did not affect long-term seizure outcome [11].…”

“…In the European TimeToStop observational study that included 766 children, the median time for initiation of AED taper was 12.5 months, suggesting that American and Canadian epileptologists begin AED tapering earlier than their European colleagues [11]. More importantly, the TimeToStop study found that early AED withdrawal did not affect long-term seizure outcome [11]. In our survey, a significant number of the respondents (45.6%) preferred to wait even longer (12 months or more) to initiate AED tapering in patients on polytherapy.…”

Seponering av antiepileptika ved anfallsfrihet – når og hvordan?

“…Flertallet av dem som er anfallsfrie to år etter operasjonen, fortsetter å vaere det i årene fremover. Noen får imidlertid anfallsresidiv etter mange års anfallsfrihet, selv ved fortsatt antiepileptikabruk (24,25).…”