RSS-Feed abonnieren

DOI: 10.1055/s-0044-1791475
Correlation of EEG Findings with Outcome in Juvenile Myoclonic Epilepsy: A Multicentric Study
Authors
Introduction: Juvenile myoclonic epilepsy (JME)—one of the most common childhood/ juvenile epilepsy syndromes accounting for approximately 5 to 10% of all cases of epilepsy. Typical EEG findings of diffuse, symmetric, bilateral 4 to 6 Hz, polyspike and wave discharges with fronto-central dominance especially in sleep and activation procedures including photic stimulation may be absent in many patients. No significant, consistent outcome predictors have been established for this very common epilepsy syndrome. Role of EEG, an easily available and fairly affordable investigation, in determining outcome in JME patients is uncertain till now. Using EEG as a tool to guide regarding management in such patients would be really helpful, especially in resource poor countries like India.
Aims: To study the prognostic significance of EEG features in patients with juvenile myoclonic epilepsy (JME).
Methods: We reviewed the records of consecutive patients with JME attending outpatient clinics at three tertiary epilepsy care centers who had a minimum follow-up of 4 years after the first visit. The diagnosis of JME was confirmed as per the international consensus criteria. The EEGs of all these patients were reviewed by two epileptologists who were blinded to clinical data. The presence of focal spikes, generalized paroxysmal fast activity, and fast rhythmic spikes on EEG were considered as atypical features. Patients with no seizures during the last 2 years of follow-up were considered seizure-free and we compared the EEG features in seizure-free and nonseizure-free patients.
Results: We identified 151 patients with JME during the study period from April 2013 to July 2018. Of these, 120 (80%) were seizure-free. A total of 50 (33%) patients had atypical EEG features, 18 (58%) in nonseizure-free group, and 32 (27%) in the seizure-free group (p < 0.005). Of the 151 patients, 72 (47%) had interictal epileptiform discharges (IEDs) during wakefulness. Seizure-free patients were less likely to have IEDs during wakefulness (41% vs. 71%, p < 0.05). Photo-paroxysmal response was equally present between the two groups.
Conclusion: EEG has a prognostic significance in patients with JME. Patients with atypical EEG features and awake IEDs are less likely to become seizure-free. Thus EEG study can help in diagnosing and tailoring the treatment of such patients.
Publikationsverlauf
Artikel online veröffentlicht:
12. September 2024
© 2023. Indian Epilepsy Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India