Juvenile myoclonic epilepsy: Long-term prognosis and risk factors
| Autor: | Nicola Pietrafusa, Luca De Palma, Angela La Neve, G. Boero, Concetta Luisi, Federico Vigevano, Nicola Specchio |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Drug Resistant Epilepsy Pediatrics medicine.medical_specialty 03 medical and health sciences 0302 clinical medicine Developmental Neuroscience Risk Factors Outcome Assessment Health Care medicine Humans In patient Longitudinal Studies Epileptic Syndrome Retrospective Studies business.industry Myoclonic Epilepsy Juvenile Remission Induction Clinical course Mean age General Medicine Middle Aged Prognosis medicine.disease Pediatrics Perinatology and Child Health Cohort Inclusion and exclusion criteria Anticonvulsants Female Neurology (clinical) Juvenile myoclonic epilepsy Extended time business 030217 neurology & neurosurgery |
| Zdroj: | Brain and Development. 43:688-697 |
| ISSN: | 0387-7604 |
| Popis: | Our goal was to investigate the long-term clinical course of juvenile myoclonic epilepsy (JME) in a cohort of patients and to identify prognostic factors for refractoriness and seizure relapse after anti-seizure medications (ASMs) withdrawal. A literature review is also presented to consolidate and compare our findings with the previously reported cases.We retrospectively studied a series of patients diagnosed with JME with 15 years or more of evolution. We collected clinical, neurophysiological and neuroimaging data from patients who met defined inclusion and exclusion criteria.Study involved 61 patients (65.5% female) with mean age at study of 37.6 years, and mean age at its outset of 14.8 years. Median follow-up was 31.0 years (mean 28.9, range 15-53). They presented more frequently with a combination of myoclonic and generalized tonic-clonic seizures (GTCS) (65.6%). Sixty-five percent of patients (n = 40) had a 5-year terminal remission with a mean age at last seizure of 27.4 years. Thirty-two percent of seizure-free patients (n = 13) withdrew ASMs: 6 out of 13 had a recurrence of the seizures while 7 remained seizure-free (mean age at ASMs withdrawal 21.0 versus 35.7 years, p 0.05). In the multivariate model, a high GTCS frequency at onset (p = 0.026) was a prognostic factor of drug resistance.JME is often regarded as a benign epileptic syndrome, although a quarter of the individuals have refractory epilepsy. The possibility of withdrawing ASMs in patients who have been free of seizures over an extended time seems feasible. |
| Databáze: | OpenAIRE |
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