Seizure and social outcomes in patients with juvenile myoclonic epilepsy (JME)

Asadi‐Pooya, Ali A.; Rostamihosseinkhani, Mahtab; Farazdaghi, Mohsen

doi:10.1016/j.seizure.2022.03.002

Cited by 3 publications

(6 citation statements)

References 13 publications

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“…We also found that 51% of the patients with JME reported driving a car or motorbike in their daily lives, similar to a previous report [ 20 ]. In Taiwan, individuals with epilepsy or seizures must disclose their condition when applying for a driver’s license and they can only obtain a license for a car or motorbike after being seizure-free for two years, as confirmed by their physician.…”

Section: Discussionsupporting

confidence: 91%

“…Of the patients in our study, 30.6% were students and not part of the workforce, while 76.5% of the remaining 34 patients were employed, which is lower than the employment rate in Taiwan as a whole, which was 96.3% in April 2019 [ 32 ]. Similar studies in Denmark and Iran also reported lower employment rates in JME patients than in the general population [ 3 , 20 ]. Notably, we found a significantly higher employment rate in the patients who were seizure-free compared to those who continued to experience seizures.…”

Section: Discussionsupporting

confidence: 53%

“…Similarly, Asadi-Pooya et al reported that only 39.3% of patients with JME experienced a seizure-free period of at least 12 months for all seizure types. However, with regard to the most debilitating type of seizure (i.e., GTC), over two-thirds of their patients with JME may achieve seizure-free status during follow-up [ 20 ]. In addition, a meta-analysis of 43 relevant studies concluded that 35% (with a 95% confidence interval of 29–41%) of patients with JME had drug-resistant seizures.…”

Section: Discussionmentioning

confidence: 99%

“…However, the marital status of JME patients did not differ significantly between those with ongoing seizures and those who were seizure-free. A previous study conducted in Denmark reported that JME patients had a lower rate of marriage than controls [ 3 ], while a study in Iran found that the rate of marriage among JME patients was similar to that of the general population [ 20 ]. Nonetheless, it has also been reported that people with epilepsy are more likely to remain unmarried than those without epilepsy [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…The long-term social outcomes for JME patients are also an important issue, with conflicting reports on the social consequences of having JME [ 3 , 19 , 20 ]. Although case series of JME patients have been reported from various countries, including India [ 18 , 21 ] and China [ 14 , 17 ], clinical studies in Asia are relatively rare.…”

Section: Introductionmentioning

confidence: 99%

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Juvenile Myoclonic Epilepsy: Seizure and Social Outcomes in Taiwan

Lim

Tseng

et al. 2023

Healthcare

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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.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Juvenile Myoclonic Epilepsy: Seizure and Social Outcomes in Taiwan

Lim

Tseng

et al. 2023

Healthcare

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Idiopathic generalized epilepsies: Which seizure type is more difficult to control?

Asadi‐Pooya

Farazdaghi

2023

Journal of Clinical Neuroscience

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

Fayad,

Saad,

Kahwagi

et al. 2024

PLoS ONE

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Introduction Juvenile Myoclonic Epilepsy (JME) is a prevalent form of epileptic disorder, specifically categorized within the realm of Genetic Generalized Epilepsy (GGE). Its hallmark features encompass unprovoked bilateral myoclonus and tonic-clonic seizures that manifest during adolescence. While most JME patients respond favorably to anti-seizure medication (ASM), a subset experiences refractory JME, a condition where seizures persist despite rigorous ASM treatment, often termed “Drug-Resistant Epilepsy” (DRE). This systematic review and meta-analysis aims to determine the prevalence of refractory JME, and further to identify socio-demographic, electrophysiological and clinical risk factors associated with its occurrence. Pinpointing these factors is crucial as it offers the potential to predict ASM responsiveness, enabling early interventions and tailored care strategies for patients. Material and methods The systematic review and meta-analysis followed the Cochrane Handbook and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study evaluated outcomes post ASM treatment in JME cohorts by searching papers published up to September 2023 in PubMed/MEDLINE, Scopus, and Google Scholar databases. Predefined inclusion criteria were met by 25 eligible studies, forming the basis for analysis. Results A total of 22 potential risk factors for refractory JME were documented. Notably, robust risk factors for treatment resistance included Psychiatric Disorder (Odds Ratio (OR), 3.42 [2.54, 4.61] (95% Confidence Inverval (Cl)), Febrile Seizures (OR, 1.83 [1.14, 2.96] (95% Cl)), Alcohol Consumption (OR, 16.86 [1.94, 146.88] (95%Cl)), Aura (OR, 2.15 [1.04, 4.47] (95%Cl)), childhood absence epilepsy (CAE) evolving into JME (OR, 4.54 [1.61, 12.78] (95%CI)), occurrence of three seizure types (OR, 2.96 [1.96, 4.46] (95%CI)), and Focal EEG abnormalities (OR, 1.85 [1.13, 3.01] (95%Cl)). In addition, there were some non-significant risk factors for DRE because of noticeable heterogeneity. Conclusion In aggregate, over 36% of JME patients demonstrated drug resistance, with seven significant risk factors closely linked to this refractoriness. The interplay between these factors and whether they denote treatment non-response or heightened disease burden remains an open question and more studies would be required to fully examine their influence.

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Seizure and social outcomes in patients with juvenile myoclonic epilepsy (JME)

Cited by 3 publications

References 13 publications

Juvenile Myoclonic Epilepsy: Seizure and Social Outcomes in Taiwan

Juvenile Myoclonic Epilepsy: Seizure and Social Outcomes in Taiwan

Idiopathic generalized epilepsies: Which seizure type is more difficult to control?

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

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