Camfield Peter, Camfield Carol
Department of Pediatrics, Dalhousie University, IWK Health Centre, Halifax, Nova Scotia, Canada.
Epilepsia. 2008 Dec;49 Suppl 9:25-8. doi: 10.1111/j.1528-1167.2008.01923.x.
When people with epilepsy become seizure-free with daily antiepileptic drug (AED) management, there is a very individual decision to be made about discontinuing this treatment. After 1-6 years of seizure-freedom, it is estimated that 69% of children and 61% of adults remain seizure-free when AEDs are tapered and stopped. The length of time that a patient is seizure-free does not influence the success rate in children but may in adults. The epilepsy syndrome does not seem to influence the chance of success in 75% of children; however, several prediction schemes based on risk factors for recurrence may be useful. There are two major risks in discontinuing treatment--a tiny risk that the epilepsy will not be controlled again and a tiny risk of death during a recurrence. Children who have had 1-2 years seizure-free deserve a chance to discontinue their AED treatment, whereas in adults this decision probably should wait until there have been at least 4 years of seizure-freedom.
当癫痫患者通过每日服用抗癫痫药物（AED）实现无癫痫发作时，关于是否停止这种治疗需要做出非常个体化的决定。在实现1至6年无癫痫发作后，据估计，当逐渐减少并停用AED时，69%的儿童和61%的成人仍能保持无癫痫发作。患者无癫痫发作的时长对儿童的成功率没有影响，但对成人可能有影响。癫痫综合征似乎对75%的儿童的成功几率没有影响；然而，基于复发风险因素的几种预测方案可能会有所帮助。停止治疗有两大风险——癫痫再次无法得到控制的极小风险以及复发期间死亡的极小风险。已经实现1至2年无癫痫发作的儿童值得有机会停用他们的AED治疗，而对于成人，这个决定可能应该等到至少已经实现4年无癫痫发作之后。
