In a 17-year-old with epilepsy, which statement is correct about anticonvulsant therapy?

• A. Aspirin can inhibit the action of anticonvulsants.
• B. Anticonvulsants must be taken frequently during the day to prevent seizures.
• C. Sudden withdrawal of anticonvulsants can lead to status epilepticus.
• D. When the seizures have been controlled, the medications can be discontinued.

Answer: (C)

Abruptly stopping anticonvulsants can trigger withdrawal seizures that may progress to status epilepticus. Anticonvulsants stabilize brain activity; removing them suddenly removes this protection, allowing a rebound of widespread, uncontrolled electrical discharges. Status epilepticus is a medical emergency where seizures persist or recur with little or no recovery between them, carrying serious risks. Because of this danger, stopping the medication must be done slowly under medical supervision, with a careful taper rather than an abrupt halt.

In practice, the goal is to maintain stable drug levels to prevent breakthrough seizures, and decisions about continuing or tapering therapy are made with careful consideration of risks and benefits over time. Some statements about needing frequent dosing, or about stopping once control is achieved, don't capture the safety principle at play here, and aspirin interactions, while clinically relevant in some contexts, do not overturn the fundamental rule that sudden withdrawal can provoke dangerous seizures.