Juvenile Myoclonic Epilepsy: Medical Treatment Response and Prognostic Factors for Complete Seizure Remission.
Abstract number :
2.175
Submission category :
Year :
2001
Submission ID :
2956
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
E. Trinka, MD, Neurology, Universitätsklinik für Neurologie, Innsbruck, Austria; J. Unterrainer, MD, Psychology, University Freiburg, Freiburg, Germany; I. Unterberger, MD, Neurology, Universitätsklinik für Neurologie, Innsbruck, Austria; G. Luef, MD, Neu
RATIONALE: To determine the prognosis for complete seizure remission in patients with juvenile myoclonic epilepsy.
METHODS: We identified 186 patients treated between 1977 and 2000 from a database in a large epilepsy outpatient clinic of a university hospital. Sixty patients were excluded. Reasons for exclusion were of loss at follow up (n=14), follow up shorter than two yrs (n=36), refusal of AED treatment (n=8), and death due to traffic accidents after the first visit (n=2). 126 were eligible for further analysis. In a retrospective design we analyzed clinical data, seizure type, provocative factors, EEG and imaging findings, family history and response to medical treatment with various AED (VPA, LTG, PRM, CLZ, ETX and TPM).
RESULTS: Of the patients 53% were female, average age at onset was 15.4 yrs (range 1-46) and at the last visit 30.3 yrs (range 14-77). EEGs with generalized spike wave discharges were found in 88.9%. Thirteen percent had additional focal EEG findings ([dsquote]pseudofoci[dsquote]). Only 44.4% of all patients, including those who were not compliant were completely seizure free during past 2 years. Multiple clinical and EEG factors were examined as predictors for outcome using a binary regression analysis. Factors predicting no remission (p[lt]0.05) included younger age at onset and poor compliance. Two thirds of seizure free pts had VPA, 40% of them as the first AED. Only 4% were seizure free when they had an AED other than VPA as the first drug.
CONCLUSIONS: More than half of pts with JME were not completely seizure free. The comparatively low responder rate can be explained by inclusion of [dsquote]pseudoresistant[dsquote] patients in this series. Poor compliance with abnormal lifestyle was a predictor for seizure recurrence. VPA was the most effective drug for achieving complete seizure remission.
Support: no funding.