Significance of the EEG and epileptiform abnormalities in antiepileptic drug discontinuance

The question of the advisability of antiepileptic drug (AED) discontinuance is common in epilepsy care. With currently available therapies, prolonged periods of seizure remission are not uncommon. After a prolonged period of seizure freedom, patients and clinicians often begin to wonder whether therapy can be discontinued. The AED discontinuance literature shows relapse rates ranging from 20% to 60%. Factors with prognostic significance have been recognized, including several findings identified on the routine EEG. This article reviews the role of EEG in the setting of AED discontinuance and summarizes the literature describing the prognostic value of EEG.