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Patterns of seizure activation after withdrawal of antiepileptic medication

From the Montreal Neurological Institute and Department of Neurology and Neurosurgery (Drs. Gotman. Andermann, and Olivier), McCill University, Montreal, Quebec, Canada: and the Clinica Neurologica (Dr. Marciani), Universita di Roma, Tor Vergata, Italy.

Effects of withdrawal of anticonvulsant drugs on the temporal profile of occurrence and the type of seizures were investigated in 40 intractable epileptic patients who were candidates for surgical treatment. EEG and behavior were monitored while drugs were ireduced to allow localization of the epileptogenic region. The rapid withdrawal of drugs caused a rebound effect, triggering either generalized seizures during a brief period or a longer-lasting increase in partial seizures. These increases in seizure frequency appeared related to change in dosage rather than to dosage itself, since they remained largely confined to the early period following reduction of an anticonvulsant.

Address correspondence and reprint requests to Dr. Gotman, Montreal Neurological Institute, 3801 University Street, Montreal, Quebec, Canada, H3A 2B4.

Supported by grant M A-7204 of the hledical Research Council of Canada to J. Gotman, who is a Chercheur-Boursier Senior du Fonds de la Recherche en Sante du Quebec.

Accepted for publication February 7, 1985.

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