Abstracts

Rationale: The long-term seizure outcome of Juvenile Myoclonic Epilepsy (JME) is still controversial; the value of factors that are potentially predictive for seizure outcome remains unclear. The aim of this study was both to investigate the long-term seizure outcome in patients with JME after a follow-up of at least 25 years and to identify factors that are predictive for the seizure outcome. Methods: Data from 31 patients (19 women) with JME were studied. All of them had a follow-up for at least 25 years (mean 39.1 years) and were re-evaluated with a review of their medical records and direct telephone or face-to-face interview. Results: Of 31 patients 21 (67.7%) became seizure-free, in 6 of them (28.6%) antiepileptic drug (AED) treatment was stopped due to seizure-freedom. The occurrence of generalized tonic-clonic seizures (GTC) preceded by bilateral myoclonic seizures (BMS) (p = 0.03), a long duration of epilepsy with unsuccessful treatment (p = 0.022), and AED polytherapy (p = 0.023) were identified as significant predictors for a poor long-term seizure outcome, whereas complete remission of GTC under AED significantly increases the chance for complete seizure-freedom (p = 0.012). The occurrence of photoparoxysmal responses significantly increases the risk of seizure recurrence after AED discontinuation (p = 0.05). Conclusions: This study shows conclusively that JME is a heterogeneous epilepsy syndrome. Life-long AED treatment is not necessarily required to maintain the patients seizure-free. Several long-term outcome predictors that can potentially increase the clinicians' ability and confidence to recommend different treatment options to patients with JME were identified.