Abstracts

Endogenous and exogenous seizure precipitants are commonly found in patients with epilepsy. Among the generalized idiopathic epilepsies, Juvenile Myoclonic Epilepsy (JME) in one of the syndromes with better defined precipitant factors (PF): sleep deprivation, stress, alcohol intake, hormone alterations and photosensitivity. The aim of this study was to evaluate the prevalence and nature of PF of seizures in a group of patients with JME through a questionnaire elaborated and based on the literature regarding these factors. Seventy-five patients, 36 men, aged between 13 and 53 years, attended at the outpatient clinic with electroclinical diagnosis of JME, answered a semi-structured interview. This included questions with reference to a list of precipitants that might trigger or exacerbate their seizures: sleep deprivation, stress, menstrual cycle, circadian cycle, alcohol, photic stimulation, watching TV, movements of the hands, thinking, listening to music, games, calculating, writing, reading, eating, drawing, speaking in public or playing a musical instrument. Inhibitory factors were also inquired about. Sixty-nine patients (91.7%) identified at least one precipitant or aggravating factor of their seizures. Men were more capable of identifying these factors (34 out of 36). Among the usual PF these patients cited sleep deprivation (77.3%), stress (82.7%), menstruation (33.3%), photic stimulation (14.7%) and alcohol intake (10.7%). Movements of the hands (28%), thinking (22.7%), speaking in public (10.7%), playing games, calculating and reading, 6.7% each, writing (5.4%), playing a musical instrument (4%) and drawing (2.7%) were also described. Despite the above mentioned numbers only 17 (22.7%) patients were able to recognize inhibitory seizure factors. Among them, being at ease, 14 (18.7%), going to sleep or exercising (1 each). Surprisingly, items rarely mentioned as PF were found in a significant percentage of cases. Unfortunately, the frequency of inhibitory factors was far from those of the precipitants. Not only the recognition of the above factors but also being aware of the importance of avoiding them is fundamental in treating patients with JME. (Supported by FAPESP (Funda[ccedil][atilde]o de Amparo a Pesquisa do Estado de S[atilde]o Paulo), CAPES (Coordena[ccedil][atilde]o de Aperfei[ccedil]oamento de Pessoal de N[iacute]vel Superior).)