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Although seizure freedom is the most important goal of epilepsy surgery, patients strongly prefer to also withdraw all antiepileptic drugs (AEDs). Despite the attention paid to epilepsy surgery outcomes, few data are available regarding whether and how AEDs can be withdrawn. In this large observational study of outcomes of attempted AED withdrawal after anterior medial temporal lobe resection (ATL), 384 patients had a median 12 years of follow-up (range, 7–17 years). Attempted withdrawal from medications followed guidelines for onset and rate of tapering AEDs.
The population was relatively uniform and well selected for high likelihood of unilateral mesial temporal seizure onset zone (89% had ipsilateral hippocampal sclerosis detected on MRI)…