Consortia for Improving Medicine with Innovation & Technology.
Department of Neurology, Massachusetts General Hospital, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Curr Opin Neurol. 2018 Apr;31(2):211-215. doi: 10.1097/WCO.0000000000000530.
As the number of patients diagnosed with epilepsy continues to rise and the pharmacological and device-based treatment options for epilepsy increase, determining when to stop antiepileptic drug (AED) treatment continues to be an important issue for patient management and counseling.
This review focuses on outcomes following AED withdrawal in seizure-free adults with epilepsy. Practical considerations are also discussed because, despite the importance of this topic, relatively little progress has been made in the past year regarding the identification of patients whose risk for recurrent seizures after AED withdrawal is no higher than that of the general population.
Although articles in the past year have updated the debates about whether and when to discontinue AEDs in seizure-free adults and have suggested potential utility for electroencephalograms as a prognostic tool for AED reduction as well as for an AED withdrawal risk calculator, decisions about AED withdrawal should still be based on the known risks and consequences of seizure recurrence and be made following well documented discussions between doctor and patient/carer.
随着癫痫患者数量的持续增加，以及抗癫痫药物（AED）和设备治疗选择的增加，确定何时停止 AED 治疗继续是患者管理和咨询的一个重要问题。
这篇综述重点关注癫痫无发作的成年患者停止 AED 治疗后的结局。还讨论了实际考虑因素，因为尽管这一话题很重要，但在过去一年中，在确定哪些患者在停止 AED 治疗后再次发作的风险并不高于普通人群方面，几乎没有取得任何进展。
尽管过去一年的文章更新了关于癫痫无发作的成年人是否以及何时停止 AED 治疗的辩论，并提出了脑电图作为 AED 减少的预后工具以及 AED 停药风险计算器的潜在效用，但 AED 停药的决定仍应基于已知的癫痫复发风险和后果，并在医生与患者/照顾者之间进行充分记录的讨论后做出。
