Abstracts

Rationale: Juvenile myoclonic epilepsy (JME) is one of the most common types of idiopathic generalized epilepsy. It is characterized by myoclonic jerks, generalized tonic-clonic seizures, and sometimes absence seizures. JME typically responds well to antiepileptic drugs (AEDs), often in monotherapy. Common practice and belief has been that lifelong treatment is required, but a recent longitudinal study (Camfield et al, 2009), suggested that a percentage of JME patients (25%) may be able to discontinue AEDs and remain seizure-free. The aim of the present study was to assess seizure frequency in a group of patients with well-defined JME, and to determine their current and previous use of AEDs. Methods: Patients with JME (n=31) were contacted . Subjects had been previously identified and consented through the Epilepsy Genetic Study at Columbia University. A questionnaire was administered by a researcher over the phone. Patients were asked about marital status, education, occupation, overall health and medication use (including current medications), age of seizure onset, current and prior seizure frequency, current and prior AED use, and medication compliance.Results: Among the 31 subjects, 55% (n=17) reported current seizure freedom for at least a year. Among the 45% who reported having seizures (n=14), 11 now had only myoclonus. Continued generalized tonic-clonic seizures were reported in only one subject and continued absence seizures were seen in three. All but one subject (97%) were still taking AEDs at the time of the interview. 22 (70%) were presently being managed with monotherapy. 5 subjects (17%) had not taken their medications consistently. Among those who had not taken their medication consistently, only one did this under the care of a physician. 93% of the subjects reported that they were in good health and 42% denied any comorbid medical problems. 48% of the subjects were married. All had completed at least some college with 74% having completed a college degree and/or an advanced degree. 84% of the subjects were employed with three of the unemployed being students. Among the subjects, 68% were women and 32% were men. The mean age was 39 2.8 years.Conclusions: In summary, 97% of the subjects were still taking medication, despite 55% of patients being seizure-free for a year or more and 11 patients having only myoclonic jerks. Those subjects with occasional myoclonus reported exacerbations when feeling over tired , and could minimize events by managing stress and limiting alcohol intake. Most of the subjects were managed with one AED, reporting good medication regimen compliance (83%). In addition, all of the patients had completed at least some college, many having completed a college degree and/or an advanced degree. Our results contrast with those of Camfield et al. Overall, these JME patients have achieved a high degree of seizure freedom or control with appropriate social functioning, but despite this, nearly all have remained on at least one AED.