Introduction. Juvenile myoclonic epilepsy is considered to be a chronic
disease requiring lifelong antiepileptic treatment. The aim of this study was
both to identify factors predicting the kind of seizure control and to
investigate the outcome in patients after therapy withdrawal. Material and
Methods. The study included 87 patients (49 female, 38 male), aged from 17.5
to 43.5 years, referred to our Department between 1987 and 2008, with the
seizure onset at the age of 14.3+2.9, and followed up for 13.3+5.8 years on
average (from 5 to 23 years). Results. Sixty seven (77.0%) patients were
fully controlled; whereas 13.8% had persistent seizures and 9.2% showed
pseudoresistance. The combination of three seizure types and focal
electroencephalogram features were independent factors of poor seizure
control. Therapy was discontinued in 34 patients either by the treating
physician (in 21 patients) or by the patients themselves (in 13 cases). In 18
subjects, all seizure types relapsed after 1.1 year on average (from 7 days
to 4 years) and therapy was resumed in them. All patients but three (10/13),
who stopped the treatment themselves, experienced recurrences. Seizure
freedom off drugs was recorded in 10.3% patients. Nonintrusive myoclonic
seizures recurred in 0.5-3 years as their only seizure type in four patients,
but without reintroducing medication in three patients. Conclusion
Combination of seizure types and focal electroencephalogram features are
significant factors of pharmacoresistancy. Continuous pharmacotherapy is
required in majority of patients, although about 10% of them appear to have
permanent remission without therapy in adolescence.
Electroconvulsive Therapy in Super Refractory Status Epilepticus: Case Series with a Defined Protocol
