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NEUROLOGY 2008;70:2123-2129
© 2008 American Academy of Neurology

Myoclonic seizures subside in the fourth decade in juvenile myoclonic epilepsy

B. Baykan, MD, E. A. Altindag, MD, N. Bebek, MD, A. Y. Ozturk, MD, B. Aslantas, MD, C. Gurses, MD, I. Baral-Kulaksizoglu, MD and A. Gokyigit, MD

From the Departments of Neurology (B.B., E.A.A., N.B., A.Y.O., C.G., A.G.) and Psychiatry (B.A., I.B.-K.), Istanbul University, Istanbul Medical Faculty, Turkey.

Address correspondence and reprint requests to Prof. Dr. Betul Baykan, Istanbul University, Istanbul Medical Faculty, Department of Neurology, Millet Cad, 34390, Capa, Istanbul, Turkey baykanb{at}istanbul.edu.tr

Objective: Our aim was to assess the long-term follow-up of juvenile myoclonic epilepsy (JME), with an emphasis on the course of the myoclonic seizures.

Methods: We enrolled 48 patients with JME (29 F, 19 M; aged 39.9 ± 9.5 years) followed up for a mean of 19.6 ± 5.7 years. The remission for 5 years and relapses were evaluated for all seizure types and the changes in severity/frequency of myoclonia were systematically questioned. The clinical and EEG features, antiepileptic drug (AED) treatment regimen, and systemic and psychiatric comorbid diseases were evaluated.

Results: We found a benign course in 66.6% whereas 16.7% had pseudo-resistance due to problems in treatment or lifestyle. The true-resistant course observed in the remaining 16.7% was significantly associated with psychiatric disorders and the presence of thyroid diseases. In 54.2% of the patients, myoclonia were in remission for a mean duration of 8.4 ± 7.7 years, after an average age of 32.9 ± 9.6. Of these patients, 6 were on a lower dose of AED in comparison to the dosage needed to control the seizures in the beginning, and 5 patients had stopped AED treatment. None of the latter 11 patients except one relapsed during the follow-up. Furthermore, 21 other patients (43.8%) described substantial alleviation after age 31.3 ± 8.4 in the severity of myoclonia.

Conclusion: Although a great majority of the patients with juvenile myoclonic epilepsy had continuing seizures after a follow-up of 20 years, almost all had either 5-year remission or a substantial alleviation of the myoclonic seizures.

Abbreviations: AED = antiepileptic drug; AS = absence seizures; CBZ = carbamazepine; GTCS = generalized tonic–clonic seizures; IGE = idiopathic generalized epilepsies; JME= juvenile myoclonic epilepsy; LTG = lamotrigine; PB = phenobarbital; PHT = phenytoin; TLE = temporal lobe epilepsy; VPA= valproate.

Disclosure: The authors report no disclosures.

Received January 28, 2007. Accepted in final form September 21, 2007.






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