Initiating and Withdrawing Medical Management

The fundamental questions regarding the medical management of children and adolescents with epilepsy are when and in which patients to initiate treatment with antiepileptic drugs, and when and in which patients to discontinue treatment. The principles that shape these decisions are discussed, to include a thorough understanding of the risks and benefits of each option, providing a foundation upon which to have a partnering interchange with the patient and their family. The individualized decision to initiate or to discontinue antiepileptic drug therapy for a patient is usually focused upon preventing the occurrences of epileptic seizures, but is ultimately centered around minimizing morbidity and mortality, and maximizing quality of life for both the patient and their family.