Juvenile Myoclonic Epilepsy: Seizure and Social Outcomes in Taiwan

Abstract

Patients with juvenile myoclonic epilepsy (JME) may not achieve seizure freedom despite optimal treatment with antiseizure medications (ASMs). The aim of this study was to investigate the clinical and social features of patients with JME, and to determine the factors associated with outcomes. We retrospectively identified 49 patients with JME (25 females, mean age 27.6 ± 8.9 years) who were assessed at the Epilepsy Centre of Linkou Chang Gung Memorial Hospital in Taiwan. The patients were divided into two groups, those who were seizure-free and those with ongoing seizures according to their seizure outcome at the last follow-up for one year. Clinical features and social status were compared between these two groups. Twenty-four (49%) of the JME patients were seizure-free for at least one year, while 51% continued to experience seizures despite being treated with multiple ASMs. The presence of epileptiform discharges in the last electroencephalogram and seizures during sleep were significantly associated with worse seizure outcomes (p < 0.05). The patients who were seizure-free had a higher employment rate compared to those who continued to experience seizures (75% vs. 32%, p = 0.004). Despite receiving ASM treatment, a considerable proportion of the patients with JME continued to have seizures. Moreover, poor seizure control was associated with a lower employment rate, which may lead to negative socioeconomic consequences related to JME.

A systematic review and meta-analysis of factors related to first line drugs refractoriness in patients with juvenile myoclonic epilepsy (JME)

“…This can be explained by the fact that there are relatively few medications that are effective against this particular form of epilepsy, such as valproate, which is still regarded as the best therapy for JME since the late 1960s [ 51 ]. These findings have led to a significant shift in the perception of JME as a benign epilepsy, necessitating caution among medical professionals when providing prognosis counseling to JME patients [ 23 ].…”

“…Mor Yam (2022) [21] Failure of adequate trials of two tolerated, appropriately chosen and used ASMs schedules Asadi-Pooya (2022) [22] Having ongoing seizures Siew-Na Lim (2023) [23] Patients who had experienced seizures in the past one year were considered to have ongoing seizures, even if the seizures occurred due to external factors such as sleep deprivation.…”