Balslev T
Paediatrisk afdeling, Aalborg Sygehus.
Ugeskr Laeger. 1996 Apr 1;158(14):1961-4.
A review is presented of factors influencing the prognosis for remaining free of seizures after withdrawal of anti-epileptic drugs. Adverse factors are found to be: a) being 16 years or older; b) having had many seizures after starting anti-epileptic drug treatment; c) a history of myoclonic seizures; d) a history of generalised tonic-clonic seizures; e) polytherapy; and f) spike and wave paroxysms in the EEG. An EEG before withdrawal of antiepileptic drugs is only required in patients with primary generalised epilepsy. The social situation and individual wishes of the patient and relatives should be considered when withdrawal of anti-epileptic drugs is being planned. Continued treatment until the patient has remained seizure-free for five years will decrease the risk of relapse. In children, anti-epileptic drugs may be withdrawn after three years of treatment, if no adverse factors are present. Nothing definite is known concerning the withdrawal procedure. A stepwise, slow withdrawal with a duration of six months or more is recommended, as this reduces the risk of relapse.
本文综述了影响停用抗癫痫药物后无癫痫发作预后的因素。发现不良因素包括：a) 年龄在16岁及以上；b) 开始抗癫痫药物治疗后发作频繁；c) 有肌阵挛发作史；d) 有全身强直阵挛发作史；e) 联合用药；f) 脑电图出现棘波和慢波阵发。仅原发性全身性癫痫患者在停用抗癫痫药物前需要进行脑电图检查。在计划停用抗癫痫药物时，应考虑患者及其亲属的社会状况和个人意愿。持续治疗至患者无癫痫发作达五年可降低复发风险。对于儿童，如果不存在不良因素，抗癫痫药物治疗三年后可以停用。关于停药程序尚无确切定论。建议采用持续六个月或更长时间的逐步、缓慢停药方法，因为这可降低复发风险。
