Epilepsy is a disease of the brain defined by any of the following conditions at least two unprovoked (or reflex) seizures occurring >24 hours apart, one unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years, diagnosis of an epilepsy syndrome. Epilepsy can cause many consequences, such as using long-term antiepileptic drugs.
It is important to know when drug administration starts and the right drug selection. The choice of type of drug is mainly based on the type of seizure. Other factors to consider are the age of the patient and the existing comorbidities. In the course of efforts to achieve seizure free, sometimes the addition of drugs or drug substitution is needed. Absolute drug substitution is done if serious side effects occur to the patient. The other indication of drug substitution is if there is no improvement in the frequency and severity of the seizure.
After a seizure-free period is reached, the next problem is when to stop the drug. Discontinuation of the drug has the consequence of the risk of recurrent seizures. But on the other hand, the cessation of AED in some cases corrects the side effects that arise from the drug. Some literatures suggest the termination of OAE begins after 3 years of seizure free. But when referring to the definition of epilepsy issued by ILAE in 2014, that epilepsy is considered to be resolved for individuals who have remained seizure-free for the last 10 years, with no seizure medicines for the last 5 years, then the cessation of the drug is carried out after 5 years of seizure-free period.