Withdrawal of antiepileptic medications following epilepsy surgery

We followed 104 patients to determine the prognosis for antiepileptic medication withdrawal following anterior temporal lobectomy for complex partial seizures. Thirty-nine of the 104 patients underwent a trial of complete medication withdrawal following a minimum 1-year seizure-free postoperative period. The likelihood of remaining seizure-free in these 39 patients was 77% at 1 year, 72% at 2 years, and 66% at 3 years. A prolonged duration of epilepsy prior to surgery significantly increased the risk for recurrent seizures. These findings suggest that patients who remain seizure-free following surgery for temporal lobe complex partial seizures have a good prognosis for remaining seizure-free following anti-epileptic medication withdrawal.