A guideline for discontinuing antiepileptic drugs in seizure-free patients
Citation Manager Formats
Make Comment
See Comments
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
To the Editor:
A practice parameter published in North America’s premier neurologic journal carries tremendous, fundamental weight. As such, nothing less than the most careful and dispassionate assessment of available knowledge will do. In “A guideline for discontinuing antiepileptic drugs in seizure-free patients,”1 I find fault with the bold-print recommendation, “EEG normalized with treatment,” as it applies to adults.
First, data from 5 retrospective studies2-6 are pooled equally with data from 3 prospective7-9 and 1 prospective and randomized study.10 The weaknesses of retrospective analysis should be widely known. Perhaps the weakest situation of all would be when retrospective studies attempt to evaluate the predictive power of some intervention, e.g., EEG prognostication upon the success of antiepileptic drug withdrawal. Also, because prospective data exist for the issue at hand, I fault even the inclusion of these studies. If included, however, did the subcommittee not read that Juul-Jensen2 found differences in EEG data to be “not significant,” that Janz and Sommer-Burkhardt3 considered the EEG to be of no prognostic significance, that Oller-Daurella et al.5 …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Dr. Dennis Bourdette and Dr. Lindsey Wooliscroft
► Watch
Related Articles
- No related articles found.
Alert Me
Recommended articles
-
Articles
Discontinuation of antiepileptic drugs after successful epilepsy surgeryYitzhak Schiller, Gregory D. Cascino, Elson L. So et al.Neurology, January 25, 2000 -
Article
Long-term outcomes of epilepsy surgery in SwedenA national prospective and longitudinal studyAnna Edelvik, Bertil Rydenhag, Ingrid Olsson et al.Neurology, August 21, 2013 -
Article
The prognostic value of the electroencephalogram in antiepileptic drug withdrawal in partial epilepsiesP. Tinuper, P. Avoni, R. Riva et al.Neurology, July 01, 1996 -
Article
Outcome after seizure recurrence on antiepileptic drug withdrawal following temporal lobectomyChaturbhuj Rathore, Malcolm K. Jeyaraj, Gopal K. Dash et al.Neurology, June 20, 2018