Survey of 100 Epileptics who have not had Seizures for Ten Years or More

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Abstract
SUMMARY: The aim of this survey was to define the criteria for eliminating medication. In the first place the patient should not have had a seizure for 10 years. So long a period may seem excessive to some, but we believe that this study demonstrates that it is not too long; even after 10 years without seizures, several patients experienced them again when medication was stopped. As to absences, it is doubtlessly unnecessary to continue anti‐petit mal medication in many patients, but in all cases it is necessary to continue treatment to prevent possible generalized seizures.We propose the following considerations in each case: the clinical‐EEG form of the epilepsy; the number of seizures suffered by the patient, absence of repeated seizures or status and early initiation of medication; absence of permanent neurological or mental deficit; negative family history of seizures; absence of other antecedents, especially in the partial epilepsies (traumatic antecedent of epilepsy, however, is generally of good prognosis); absence of paroxysmal EEG abnormalities or prompt normalization of the EEG with medication (persistent focal activity does not however contraindicate eliminating medication when there have been no seizures).Abrupt elimination of medication is contra‐indicated; medication should be reduced slowly, generally over a period of more than 1 year. An increase in EEG abnormalities on reduction of medication makes a return to previous doses obligatory.Using these criteria, we have been able to eliminate medication in nearly half our patients. It is of course possible that some of them may have new seizures; according to Juul‐Jensen (1968), seizures may reappear as long as 5 years after medication has been stopped.