Electroclinical and Historical Features Related to Response to AEDs in Juvenile Myoclonic Epilepsy
Abstract number :
3.197
Submission category :
4. Clinical Epilepsy / 4D. Prognosis
Year :
2017
Submission ID :
350062
Source :
www.aesnet.org
Presentation date :
12/4/2017 12:57:36 PM
Published date :
Nov 20, 2017, 11:02 AM
Authors :
Iffat A. Suchita, UT Health San Antonio; Samiya Rashid, UT Health San Antonio; Lola C. Morgan, UT Health San Antonio; Kameel M. Karkar, UT Health San Antonio; Octavian V. Lie, UT Health San Antonio; Linda D. Leary, UT Health San Antonio; Ishan Adhikari, U
Rationale: Juvenile myoclonic epilepsy (JME) is one of the most common types of idiopathic generalized epilepsy. The goal of this study was to evaluate electroclinical factors, which may help predict a poor response to AED therapy. Methods: This study is a retrospective case review. People with JME were identified based upon history of generalized myoclonic and tonic-clonic seizures beginning by early adulthood. Electroclinical findings were compared between JME patients with and without a family history of epilepsy (defined as history of epilepsy extending to grandparents and cousins), including age of onset, gender, EEG findings, and medication response. Furthermore, we compared electroclinical markers between people with medically controlled and refractory JME (defined by GTCS occurring in the last 6 months), including age of onset, gender, family history and EEG findings. We identified 56 people (mean age of onset 17 years, epilepsy duration 15 years, 66% female, 95% with EEG results) with JME. Results: A family history of epilepsy was evident in 45%, with no difference in age of onset or gender, but a slightly higher prevalence of generalized polyspikes and spike-and-wave complexes on routine EEG compared to people without family history. 62% of JME patients were medically controlled. There was no difference in age of onset, EEG findings or family history. Gender, however, may play a role, as males were proportionately more likely to remain medically refractory (Chi-square, p=0.0013, Figure). Conclusions: This retrospective study identified potential gender effects with respect to response to AED therapy. Also the proportion of medically refractory patients was high, 38% compared to 10-20% in the literature, which may have been due to a referral bias. Furthermore, specific EEG markers, including photosensitivity and focal findings, in addition to spontaneous interictal epileptic discharges and degree of relatedness, need to be evaluated in a larger group of patients, ideally recruited prospectively. Funding: None
Clinical Epilepsy