The safety of antiepileptic drug (AED) withdrawal in 65 children with cerebral palsy (CP) who had been seizure-free for at least 2 years was investigated in the Neurology Department, Texas Scottish Rite Hospital for Children, Dallas. Seizure relapses occurred in 27 patients (41%). Those with spastic hemiparesis had the highest relapse rate (61%) and spastic diplegia was associated with the lowest rate (14%). Mental subnormality, epileptiform EEG abnormality, type of CT abnormality, family history of epilepsy, mono or polytherapy, and gender were not correlated with risk of seizure relapse. [1]
COMMENT. Despite abnormal neurologic examinations, almost two thirds of these CP patients remained free from seizures for periods of at least 2 years after AED withdrawal. Patients with spastic hemiparesis have the highest relapse rate, and drug withdrawal should be discouraged or attempted only with great caution.