We thank Dr. Sethi for his interest in our article1 and thoughtful comments. We agree that a one-size-fits-all approach to antiepileptic drug (AED) discontinuation would not make sense; as we stated in the Introduction, ultimately this remains an individualized decision. Nevertheless, there are several clinical scenarios that may potentially represent a rather homogeneous population of patients, for example those with juvenile myoclonic epilepsy or those who underwent a successful uncomplicated temporal lobectomy (with all the caveats related to driving status and access to care that were eloquently detailed by Dr. Sethi), who could be studied with an appropriate model for prediction of seizure recurrence after AED discontinuation at different time points. This model could potentially represent a useful clinical tool to be utilized in conjunction with several other clinical, personal, and socioeconomic factors when making an individualized decision about AED withdrawal.
Footnotes
Author disclosures are available upon request (ncpjournal{at}neurology.org).
- © 2018 American Academy of Neurology
References
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