American Board of Internal Medicine (ABIM) Certification Practice Exam

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What is the risk of seizure recurrence after discontinuing AEDs in patients who have been seizure-free for 2-4 years?

10-20%
20-30%
30-40%
40-50%

The correct answer is: 30-40%

The risk of seizure recurrence after discontinuing antiepileptic drugs (AEDs) in patients who have been seizure-free for 2-4 years is generally recognized to be within the range of 30-40%. This estimation is based on long-term studies examining individuals with epilepsy who have achieved a significant period without seizures. Patients who remain seizure-free for this duration are considered to be in a more favorable situation, as longer seizure freedom typically correlates with a lower risk of relapse. However, the 30-40% range reflects a substantial risk of recurrence still, highlighting that although the likelihood of experiencing a seizure again decreases significantly with time, it never completely disappears. Various factors can influence this risk, including the underlying cause of epilepsy, the presence of other neurological conditions, and individual patient characteristics. Other options, such as lower percentages, do not adequately capture the increased risk faced by this specific cohort of patients after AED cessation, which is why the 30-40% range is the most accurate representation of the expected outcomes in clinical practice.