Prognosis of Juvenile myoclonic epilepsy with eye-closure sensitivity. (November 2018)

• Record Type: Journal Article
• Authors: Uchida, Carina Gonçalves Pedroso; de Carvalho, Kelly Cristina; Guaranha, Mirian Salvadori Bittar; Guilhoto, Laura Maria Figueiredo F.; de Araújo Filho, Gerardo Maria; Yacubian, Elza Márcia Targas
• Is Part Of: Seizure. Volume 62(2018)
• Page Start: 17
• Page End: 25
• Publication Date: 2018-11
• Subjects: Juvenile myoclonic epilepsy -- Eye closure sensitivity -- Eyelid myoclonia -- Prognosis; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2018.09.006
• Languages: English
• ISSNs: 1059-1311

Abstract

Highlights: Eye closure sensitivity is underestimated in JME. Eyelid myoclonia is a persistent type of seizure in JME. Photosensitivity is not an independent variable for prognosis. Eye closure sensitivity is related to a worse outcome regarding control of all seizure types. Abstract: Purpose: Eye closure sensitivity (ECS) has been described as a reflex trait in juvenile myoclonic epilepsy (JME). However, there is no consensus regarding its significance on prognosis. The aim of this study is to clarify the long-term impact of ECS documented by a clinical interview and a video-EEG neuropsychological protocol (VNPP) in a series of 133 JME patients. Methods: Data from 22 JME patients with ECS confirmed by a VNPP (Group 1) were compared with those of 20 JME patients without any reflex traits (Group 2). They were followed for a mean of 8.21 years (SD=±5.044). The frequency of seizures was assessed using a diary. Except for photosensitivity (PS), any other reflex traits occurrence, drugs/alcohol abuse intake, noncompliance, and Jeavons syndrome, were considered exclusion criteria. Results: Group 1 had a lower age at epilepsy onset (p = 0.028), higher incidence of febrile seizures (13.6%), and familial history of epilepsy (p = 0.023). Only 18.2% had self-perception of eyelid myoclonia (EM) (kappa coefficient = 0.193), which persisted in 77.3% of patients. Limb myoclonia, tonic-clonic seizures (TCS) and/or myoclonic-tonic-clonic seizures (MTCS), as well as absences were more frequent (p = 0.015; p = 0.013; p = 0.011, respectively) in Group 1. PS did not influenced frequency of EM (p = 1.0), absences (p = 0.648), or TCS/MTCS (p = 0.934). Psychiatric comorbidities were not different between groups. Conclusions: ECS is related to a worse outcome regarding control of all seizure types, persistence of EM, and higher frequency of limb myoclonia, as well as the total number of TCS and/or MTCS.