Antiepileptic drugs withdrawal in children: An update

Background: Stopping antiepileptic drugs is routinely done in patients who have epilepsy in remission. However, in literature there are no unique data that can lead to the constant application of a universally accepted suspension protocol. Methods: In this manuscript, our purpose was to revise literature scientific articles of the last 10 years concerning antiepileptic drugs withdrawal in pediatric age. Results: At the time of suspending antiepileptic treatment, it is necessary to consider three main questions: 1) why suspend therapy; 2) when and to which patients suspend it; 3) how to discontinue treatment. Therapy is suspended when it is no longer necessary, for concerns related to toxicity/side effects of antiepileptic drugs (behavioral, cognitive and chronic side effects) and since the remission of ongoing therapy seizures is possible in the 65-85 % of patients. Conclusion: In order to decide when and to which patients withdraw antiepileptic drugs, it is necessary to consider factors related to patients themselves, to characteristics of epilepsy and to the specific pharmacological treatments