Background: After a reasonable seizure free period, discontinuation of antiepileptic drugs (AED) is usually decided despite the risk of seizure recurrence in epileptic patients. The objective of the study was to identify the factors associated with seizure control and recurrence after a 2 year remission in children with epilepsy.

Methods: Epileptic patients with age of onset of seizure  less than 15 years who  were followed at least 2 years after drug  withdrawal  at a child neurology centre formed the study population of this retrospective study. Based on the outcome after stopping the medication, the patients were divided into 2 groups: Seizure relapse (SR) group and Non seizure recurrence (NSR) group. Bivariate and multivariate analyses were used to compare the clinical findings, electroencephalograms and parameters related to treatment.

Results: Of 100 patients (62 boys, 38 girls) overall recurrence rate was 38%. Most relapses occurred within first one year after withdrawal of AED.  The following factors are strongly associated with SR:  initial high seizure frequency, cognitive impairment, abnormal EEG before withdrawal and duration of withdrawal of drug.

Conclusion: The relapse rate in our study was almost similar to the most commonly reported overall rates for childhood onset epilepsy. We found that initial high seizure frequency, abnormal EEG when AED stopped are important predictors of SR in childhood epilepsy.