Background: There exists poor evidence-base and conflicting literature regarding optimum duration of anti-epileptic drugs for acute symptomatic seizures in central nervous system infections.

Methods: Children aged 3-months to 12-years having Acute Encephalitis Syndrome with acute symptomatic seizures receiving single anti-epileptic drug at 4-weeks of illness and without seizure recurrence from day 7- day 28 of illness were included in this comparative, parallel group assignment, open label, randomized control study. The exclusion criteria were included children with chronic meningitis, prior history of seizures, prior focal neurological deficit or any developmental delay, ≥ 2 anti-epileptic drugs and severely affected children were excluded. They were randomly allocated to receive anti-epileptic drugs either for 4-weeks or 12-weeks. The primary outcome was proportion of children developing seizure recurrence over 6-months follow up. The secondary outcome was to study seizure recurrence over 12-24 months follow up and factor(s) associated with seizure recurrence.

Results: Out of 232children with Acute Encephalitis Syndrome, 60children were found to be eligible for randomization in two groups. Baseline demographics were comparable (except duration of illness) between the groups. None of the children developed any seizure recurrences in the 6 month follow up period. After 18months of follow up, 1 and 5 children in 4 and 12 weeks groups developed seizure recurrence respectively(p>0.05)

Conclusions:

The present study suggests that a shorter duration (4-weeks) of anti-epileptic drug therapy is comparable with 12-weeks anti-epileptic drugs for preventing seizure recurrences over a six-month follow-up period in this cohort of children with Acute Encephalitis Syndrome.