2023 American Academy of Neurology Abstract Website

Objective:

To analyze the long-term remission in people with Juvenile Myoclonic epilepsy (JME) and determine the predictors of long-term remission.

Background:

One third of people with Juvenile myoclonic epilepsy (JME) do not respond to anti-seizure medications (ASMs) and in the remaining, seizure relapses are not uncommon when attempting to withdraw the ASMs.

Design/Methods:

This is a retrospective observational study of persons with JME with a follow-up of 5 to 20 years. The clinical details, inter-ictal EEG and ASM response details were recorded.

Results:

A total of 231 patients were included; 64% of the patients had an age of onset of 11-18 years (mean age 14.6 years). 38% had positive family history. Nearly 52% patients had a delay in the diagnosis of JME by > 1year. Among the seizure types, GTCS was noted in 96.1% patients while absence seizures were reported in 24.5%. Nearly 22% patients had all types of seizures. 36% had praxis induced seizures. Photo Paroxysmal Response (PPR) was noted on the EEG in 47% patients; Focal EEG abnormalities were noted in 29% patients. Motor seizures during sleep was reported in in 41.5% patients. The longest freedom of any seizure type for more than 10 years was achieved in 11%, more than 5 years achieved in 40% yet recurrence of any seizure after withdrawal was noticed in 70% of patients. Presence of all three seizure types, praxis induced seizures, positive PPR and focal EEG abnormalities were the predictors of poor remission.

Conclusions:

Long term follow-up showed despite long periods of seizure freedom recurrence rates following anti-seizure medication withdrawal were high. Presence of all three seizure types, praxis induced seizures, positive PPR and focal EEG abnormalities were the predictors of poor remission in people with JME.