Drug withdrawal after successful epilepsy surgery: how safe is it?

Epilepsy Behav. 2009 Aug;15(4):476-80. doi: 10.1016/j.yebeh.2009.05.016. Epub 2009 Jul 9.


Discontinuation of antiepileptic drugs (AEDs) is one reason patients undergo epilepsy surgery, but little is known about the risk of seizure recurrence. We describe a prospective pilot study of withdrawal performed at our epilepsy center. Sixty completely seizure-free patients were included between 1997 and 2003. AED withdrawal was proposed 1 year after surgery after a detailed discussion of the risks and benefits. On the basis of their decision on withdrawal, patients were stratified into two cohorts (withdrawal group, N=34; control group, N=26). Discontinuation was carried out in small tapering steps over 1 year with yearly follow-up visits. Withdrawal was stopped when seizures recurred or the patients objected to further discontinuation. Twenty-six of 34 (76.5%) persons in the withdrawal group and 16 of 26 (61.5%) persons in the control group were seizure free 5 years after surgery. In this study, AED discontinuation 1 year after successful epilepsy surgery was not associated with a risk of seizure recurrence higher than that of controls.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Anticonvulsants / adverse effects*
  • Anticonvulsants / therapeutic use*
  • Anxiety / psychology
  • Cohort Studies
  • Electroencephalography
  • Epilepsy / drug therapy*
  • Epilepsy / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Risk Factors
  • Seizures / prevention & control
  • Substance Withdrawal Syndrome / psychology*
  • Treatment Outcome
  • Young Adult


  • Anticonvulsants