The effect of seizure-free period on seizure recurrence following antiseizure medication withdrawal: a systematic review and meta-analysis

The seizure-free period before withdrawal is an important factor that influences the risk of epilepsy relapse. Our study aimed to evaluate the effect of the seizure-free period on the relapse risk after antiseizure medication(ASM) withdrawal in epilepsy populations and identify the optimal timing of ASM withdrawal.

The Cochrane Central Register of Controlled Trials, PubMed and Web of Science were searched for literature published from inception to November 2, 2025. The primary outcome was the relapse risk of epilepsy patients after ASM withdrawal. Random-effects meta-analysis models were used to estimate the pooled recurrence risk based on heterogeneity.