Troublesome seizures disappear and antiepileptic drug treatment is no longer needed in many subjects with juvenile myoclonic epilepsy on long-term follow-up. However, unfavorable social outcomes, such as not completing high school and unplanned pregnancy, are common in this group. “Juvenile myoclonic epilepsy (JME) is a well-known idiopathic generalized epilepsy syndrome usually beginning in adolescence,” Drs. Carol S. Camfield and Peter R. Camfield, from Dalhousie University, Halifax, Nova Scotia, Canada, write. “The social outcome in JME has not been extensively investigated,” they explain.

The researchers studied a population-based cohort to examine the long-term seizure and social outcome of JME. Included in the study were all patients who developed JME by 16 years of age in Nova Scotia between 1977 and 1985. The patients were contacted in 2006 to 2008, and the authors reviewed their medical records. Results are reported in the September 29th issue of Neurology.

Of 692 children with newly diagnosed epilepsy, 24 (3.5%) had JME. The age at the first seizure was 10.4 years. Of these 24 patients, 23 (96%) were contacted more than 20 years later at a mean age of 36 years.

All 23 patients were initially treated with antiepileptic drugs. Eight patients (35%) had status epilepticus, and three had intractable epilepsy. Overall, 11 patients (48%) had discontinued treatment by the end of the study. Of these 11, six were seizure-free, three had myoclonus only, and two continued to have rare seizures.

At least one unfavorable social outcome was noted in 17 subjects (74%), the report indicates.

Overall, 14 patients (61%) had received a mood altering medication during the follow-up. Nine patients received antidepressant medications. Sixteen subjects (70%) lived with a spouse or partner and seven lived alone at the end of follow-up. Of the 17 women in the study, 10 (58%) had at least one pregnancy, and four of the six men fathered children. At least 11 of the pregnancies (80%) were unplanned and were outside of a stable relationship.

Eighty-seven percent of the subjects had graduated from high school, and 70% had sought additional education. Still, only 69% of the patients were employed at the end of follow-up.

Despite the high rate of unfavorable social outcomes, the authors report that 65% to 77% of the patients reported that they were very satisfied with their health, work, friendships, and social life at the end of follow-up.

“There was no clear relationship between social outcome and seizure outcome,” the investigators explain. “In the 17 with at least one unfavorable social outcome, eight were no longer receiving antiepileptic drugs at the end of follow-up and four of the eight were seizure-free,” they note. “There is no statistical difference compared to the 16 who had no adverse social outcomes.”

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