Electroclinical and Historical Features Related to Response to AEDs in Juvenile Myoclonic Epilepsy. (P4.259)

Objective: Juvenile myoclonic epilepsy(JME) is one of the most common types of idiopathic generalized epilepsy. The goal of this study was to evaluate electroclinical factors, which may help predicting a poor response to AED therapy. Background: Studies have shown, 10–20% JME patients have medically refractory seizures. In spite of heavy disease burden, unfortunately there is not enough studies done to help guiding the physicians to counsel the patients or families regarding the possibilities of response to AED Design/Methods: This retrospective case review was done on 56 people(mean age of onset 17 years, epilepsy duration 15 years, 66% female, 95% with EEG results) with JME. Electroclinical findings; including age of onset, gender, EEG findings, and medication response; were compared between JME patients with and without a family history of epilepsy(defined as history of epilepsy extending to grandparents and cousins). Furthermore, we compared electroclinical markers; including age of onset, gender, family history and EEG findings; between people with medically controlled and refractory JME(defined by GTCS occurring in the last 6 months). Results: A family history of epilepsy was evident in 45%, with no difference in age of onset or gender, but a slightly higher prevalence of generalized polyspikes and spike-and-wave complexes on routine EEG compared to people without family history. 62% of JME patients were medically controlled. There was no difference in age of onset, EEG findings or family history. However, gender may play a role, as males were proportionately more likely to remain medically refractory(Chi-square, p=0. 0013, Figure). Conclusions: This retrospective study identified potential gender effects with respect to response to AED therapy. Also the proportion of medically refractory patients was higher, 38% compared to 10–20% in the literature, which may have been due to a referral bias. Furthermore, specific EEG markers, including photosensitivity and focal findings, in addition to spontaneous interictal epileptic discharges and degree of relatedness, need to be evaluated in a larger group of patients, ideally recruited prospectively. Study Supported by: n/a Disclosure: Dr. Suchita has nothing to disclose. Dr. Rashid has nothing to disclose. Dr. Szabo has nothing to disclose. Dr. Morgan has nothing to disclose. Dr. Karkar has nothing to disclose. Dr. Lie has nothing to disclose. Dr. Leary has nothing to disclose. Dr. Adhikari has nothing to disclose.