Hello,

In your particular case my approach would've been to carry out a FULL and EXTENSIVE neurological survey at the very beginning to discover whether you had any evidence for a seizure disorder coming about as the result of a physical or architectural cause in the brain, the circumstances behind the start of the seizures, etc.

This is usually quite extensive and can take some time to complete. Once that's done and I'm convinced the patient is free and clear of any physical cause and once I know that epilepsy does not run in a blood relative I feel comfortable recommending the patient go on medication for at least 2 years after which we can withdraw the medication and see how they do.

If seizures return then, I would once again perform a thorough evaluation to once again try and find something we may have missed the first time but the patient would be returned to medication and again placed on for another minimum of 2-3 years.

I might at this point also send the patient for genetic consultation to see what might be considered since there could be a known mutation you could be carrying that causes this in which case we then, know you must remain on medication for life.

If not then, again, at the end of the 2nd 2-3 year period and with proper physician supervision and vigilance to often include EEG testing after medication withdrawal along with symptom monitoring using a seizure diary the patient could be removed.

I would not advise you to undertake to withdraw your own medication without consulting a specialist. I recommend you see an epileptologist.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Dariush Saghafi, Neurologist