The Effect Of Seizure Type, Age at Onset and Drug Protocols on Prognosis of Juvenile Myoclonic Epilepsy

OBJECTIVE: The aim of this study is to evaulate the effect of age at
seizure onset, seizure types, drugs protocols and the duration of
treatment delay on prognosis in juvenile myclonic epilepsy (JME).
METHODS: The study included 32 patients (23 women, 9
men; mean age 22.2 ± 4.8 years; range 16 to 37 years) with JME
according to ILAE clasification (1989). Clinical characteristics of patients
including gender, age at seizure onset, seizure types, duration of delay
in the initiation of therapy, treatment protocols, response to therapy,
interictal electroencephalography (EEG) and magnetic resonans imaging
(MRI) were reviewed.
RESULTS: The seizures started at or after 12 years of age in 75 % (n: 24)
of the patients. All of our patients had multiple seizures types; 68.7 %
(n: 22) of our cases had three types and 31.2 % (n: 8) had two types.
Thirty one percent were diagnosed as JME and placed on therapy within
one year of disease onset, howewer 68.7 % (n: 22) of the cases had a delay in the diagnosis and treatment by a mean of 4.5 (1-14) years. The
patients were followed up for a mean of 5.4 (1-13) years. In this study
we found that 37 % of patients were seizure free and 62.5 % had
partially controlled seizures at the end of our follow -up.
CONCLUSION: The prognosis was very good in patiens on monotherapy
(p: 0.034), and it was better in patients with disease onset after 12 years
of age. On the other hand, prognosis was very good in patiens who
had two types of seizures compared to the ones with three types
(p: 0.001). Seizures were under control in 50 % of patients who did not
have any delay in diagnosis and therapy and only in 21.8 % of patients
with a delay in the initiation of therapy.