Tapering of anticonvulsant therapy in children.

Clinical scenario: A 12 year old girl with primary generalised epilepsy comes to clinic for review. She has been seizure free for two years on sodium valproate 600 mg twice daily. Following discussion with her and her mother, an agreement is reached to withdraw the medication. You advise that the medication should be tapered off over a six week period. At this point the mother informs you that when she had her own anticonvulsant medication withdrawn, this was reduced over a six month period. She questioned whether it was appropriate to reduce the medication so quickly and requested evidence to support the recommendation, raising concerns about the possibility of a higher risk of seizure recurrence.