Discontinuation of antiepileptic therapy presents a challenge for physicians and patient. Many parameters play a role, and the doctor has to assess the relationship between benefits and any possible damages caused by this act. The final decision should be made with the parents and the patient. In this study, we assessed the role of various factors on the possibility of relapse of epileptic seizures after discontinuation off antiepileptic therapy. We studied a cohort of children with partial epilepsy. Discontinuation was performed from 2001-2007. The study included 93 children divided into groups according to age of diagnosis and the introduction of antiepileptic therapy, the type of seizures, etiology, neurological and psychological status, the results neuroimaging studies, family history, history of febrile seizures, antiepileptic therapy, EEG registration before discontinuation of the treatment, speed of tapering therapy. Multivariable analysis was made, binary logistic regression. Factors that showed statistical significance were: age at the diagnosis, duration of active epilepsy, neurological and psychological status, EEG registration before discontinuation of therapy, the length of the period without seizures before discontinuation of the therapy and length of tapering the therapy.It is necessary to pay attention to the factors affecting increased risk of relapse of epileptic seizures when discontinuing the antiepileptic therapy in patients with partial epilepsies. This should be discussed with parents and patients, and consensus has to be reached. Doctor and patient must be aware that the risk of recurrence of epileptic seizures is high.

Early posttraumatic epilepsies (EPTE) are epileptic attacks that appear in first seven days after brain injury, with incidence of 3-5%. Predictors for development of EPTE are: impressive skull fracture with rupture of dura, intracranial haemorrhage, neurogical deficit (brain contusion), and posttraumatic amnesia longer than 24 hours. It is more common in children than in adolescents and adults. It carries four times increased risk for development of late posttraumatic epilepsy. Aspects of pharmacological prophylaxis was often considered, but scientifically neglected, without clear standings regarding controversial data in literature. Patients with severe head injury, hospitalised at Neurosurgical Hospital and Pediatric Hospital, Clinical Centre University of Sarajevo, in period from 6th of April 1992 till 1st of July 1994, were included in study. Prophylaxis of EPTE was carried out with phenobarbital (2-3 mg/kg) or phenytoin (3 mg/kg) parenterally. Decision was made upon clinical findings. CT scan was done in 13.5% patients, and in 31.9% patients serum concentrations of antiepileptic drugs were monitored. 310 patients aged 0-18 years (105 patients 0-10 years, and 205 patients 11-18 years) were investigated. Predictors of EPTE presented were posttraumatic amnesia longer than 24 hours in 90.6%, neurogical deficit in 86.45%, impressive skull fracture with rupture of dura in 81.3% and intracranial haemorrhage in 40.6%. Only two boys developed EPTE in first 24 hours after injury. This study has showed that use of antiepileptic drugs can decrease incidence of EPTE. However, problem remains, management of injured patients is still highly individualised, based on different experiences of doctors that treat patient, and without clear guidelines.