A correct diagnosis of JME does not guarantee an optimal response to therapy. Poorer drug adherence might result in more seizures; this should be highlighted for patients in every single visit. Longer follow-up gives the treating physician more time to adjust the drug(s) and formulate a plan that is appropriate for patients with difficult to treat seizures. We recommend valproate if seizure control is the main objective.

Because most descriptive studies did not specifically analyze the syndromes of idiopathic generalized epilepsy (IGE), including juvenile myoclonic epilepsy (JME), epidemiologic data concerning these syndromes are scarce or often unreliable. In this retrospective chart review study, all patients with a clinical diagnosis of JME were recruited at the outpatient epilepsy clinic at Shiraz University of Medical Sciences, from 2008 to 2013. Demographic variables and relevant clinical and EEG variables were summarized descriptively. 2,750 patients with epilepsy were registered at our epilepsy clinic; 239 patients (8.7 %) were diagnosed as having JME. Female to male ratio was 1.7. Age at seizure onset was 15 ± 3.5 years. Generalized tonic-clonic seizures were reported by 225 patients (94.1 %) and absences by 90 (37.6 %). Electroencephalography (EEG) was abnormal in 69.6 % of the patients. JME is one of the most common syndromes of IGEs. The key element in making the correct diagnosis is obtaining a detailed clinical history. MRI or laboratory tests in a patient, in whom you are suspecting JME are not necessary. Even EEG has some limitations and normal or even atypical findings in a patient with typical history for JME should not deter from the correct diagnosis.

Background: Status epilepticus (SE) is one of the most common neurological emergencies with high mortality and morbidity. This study aims to determine the most common causes and outcomes of SE in adult patients from Fars Province in southern Iran. Materials and Methods: 134 patients with SE (either convulsive or non-convulsive), admitted to Namazi Hospital, were enrolled from January 2006 to February 2012. We designed a questionnaire to collect the patients' demographics and disease characteristics and their outcomes according to Glasgow Outcome Scale (GOS). Statistical analyses were performed using SPSS software version 15. P-value<0.05 was considered statistically significant. Results: Seventy patients were female and 64 were male with mean age of 42.97±19.66 years and 39.42±18.89 years old, respectively. Sixty-two patients (46.26%) had a history of epilepsy, and 72 patients (53.73%) had no history of epilepsy. Antiepileptic drugs (ADEs) withdrawal and cerebral infarction were the most common causes of SE in epileptics and non-epileptics, respectively. One hundred and twenty-three patients (91.8%) had generalized tonic-clonic SE. Thirty patients (22.4%) could return to work and 33 (24.6%) died during hospitalization. There was a significant relationship between mortality and age over 60 years (P<0.001), and mortality and cerebral infarction or anoxia (P= 0.022). Conclusion: ADEs withdrawal in the epileptic patients was the main cause of SE (28.40% of the total population and 62% of the epileptic patients) that can be prevented by patient and family education. This study showed that high mortality and morbidity were significantly related to the increasing age and etiology of SE.

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