People may have brain surgery for their epilepsy, in part to allow them to get off antiepileptic medicines. How often does this happen? A group in Germany (Kerling and colleagues, Epilepsy & Behavior 2009, volume 15, page 476) followed 60 patients who were seizure-free for one year after epilepsy surgery. After a discussion of potential risks and benefits, 34 patients chose to discontinue seizure medicines and 26 chose to continue. Discontinuation was very slow, typically over a year, usually one drug at a time. Among those who stopped AEDs, 77% were seizure-free for 5 years, compared to 62% of those remaining on AEDs. Therefore, it appears reasonable to consider withdrawing AEDs if seizure-free for at least a year after surgery.

Robert S. Fisher, M.D., Ph.D.
Editor-in-Chief, epilepsy.com