Epilepsy is one of the most common chronic brain diseases,and taking anti-seizure medications(ASMs)is the main treatment method.When patients with epilepsy achieve long-term remission,gradually reducing ASMs has become a common concern for both patients and doctors.However,there is significant heterogeneity in current research on withdrawal of epilepsy medication.This article provides a literature review on whether patients with epilepsy who have been taking ASMs for a long time without seizures can be withdrawn,how long it takes to withdraw without seizures,how to withdraw medication,recurrence and prognosis after withdrawal,and factors affecting recurrence and prognosis.

Epilepsy is one of the most common chronic brain diseases,and taking anti-seizure medications(ASMs)is the main treatment method.When patients with epilepsy achieve long-term remission,gradually reducing ASMs has become a common concern for both patients and doctors.However,there is significant heterogeneity in current research on withdrawal of epilepsy medication.This article provides a literature review on whether patients with epilepsy who have been taking ASMs for a long time without seizures can be withdrawn,how long it takes to withdraw without seizures,how to withdraw medication,recurrence and prognosis after withdrawal,and factors affecting recurrence and prognosis.

Epilepsy surgery is an effective treatment of drug-resistant epilepsy.Once patients became seizure free for certain period after epilepsy surgery,whether anti-seizure medications(ASMs)could be withdrawn is the primary concern of clinicians and patients.However,there is no consensus about management of anti-seizure medications in patients after epilepsy surgery.Patients after epilepsy surgery can withdraw ASMs when they become seizure free for 1 to 2 years.The dose reduction is usually done at every 2 to 3 months.For patients receiving multiple ASMs,each one should be individually tapered completely prior to the subsequent medication and the primary medication is always withdrawn in the end.Longer epilepsy duration prior to surgery,older age at surgery,patients with focal cortical dysplasia,incomplete resection of the epileptogenic zone and presence of interictal epileptiform discharges in postoperative EEG may predict the risk of seizure relapse in patients who underwent ASM withdrawal after epilepsy surgery.Patients with seizure relapse on ASM withdrawal generally have benign outcome after reinstitution of medical treatment.