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Epilepsy – AED Withdrawal Counselling — SCE Neurology MCQ

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ModerateEpilepsy & Seizure DisordersEpilepsy – AED Withdrawal CounsellingSCE Neurology

A 35-year-old woman with epilepsy has been seizure-free on lamotrigine for 5 years. She asks about stopping her medication. According to NICE NG217, what should she be counselled about?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — She should be advised that there is a risk of seizure recurrence — approximately 40–50% within 2 years of AED withdrawal — and the implications for driving must be discussed

NICE NG217 advises discussing AED withdrawal after ≥2 years of seizure freedom, with full counselling about the risk of recurrence (approximately 40–50% within 2 years). The implications for driving (must stop driving during withdrawal and for 6 months after complete cessation), employment, and lifestyle must be discussed. The decision should be shared between patient and clinician. A: 5 years seizure-free does not mean 'cured'. C: The recurrence risk is substantial. D: Withdrawal is done gradually in the community. E: Withdrawal can be considered if the patient wishes.

Reference: NICE NG217 (2025); DVLA – Assessing Fitness to Drive (2025)