Initiating ASM withdrawal within the first 2 postoperative years was linked to a higher initial risk of seizure relapse compared with later withdrawal, although long-term outcomes were similar regardless of withdrawal timing. Waiting more than 2 years did not confer additional benefit in reducing seizure risk. Deciding whether and when to withdraw ASMs is a shared process involving individuals, caregivers, and clinicians, balancing preferences, risk of injury, social factors (e.g., driving, work, and supervision), and clinical judgment. Transparent information on risks and benefits is essential. Our findings offer real-world evidence that may inform future evidence-based withdrawal protocols and follow-up strategies.
Ferreira-Atuesta et al. (Tue,) studied this question.