Abstract
Juvenile myoclonic epilepsy (JME) is a common epilepsy syndrome, well defined by its myoclonic seizures. Despite typical symptoms and EEG changes, JME is underdiagnosed and oftentimes inadequately treated with sodium channel blocking antiepileptic drugs (AEDs) like carbamazepine, oxcarbazepine and phenytoin. We have analyzed the treatment of 175 JME patients from our epilepsy service. Upon first presentation to our clinic, 42 patients (24%) were treated with sodium channel blocking AEDs, of whom only one patient was seizure free. After changing the therapy to mostly valproic acid or lamotrigine, 42% of these patients were seizure free. These numbers underline the importance of the syndrome diagnosis and an adequate AED choice in treating JME.
Zusammenfassung
Die juvenile myoklonische Epilepsie (JME) ist ein häufiges, durch generalisierte myoklonische Anfälle gut definiertes Epilepsie-Syndrom. Trotz der typischen Symptome und EEG-Veränderungen wird die juvenile myoklonische Epilepsie zu selten diagnostiziert und infolgedessen häufig mit inadäquaten Antiepileptika (AE), Natriumkanal-Blockern wie Carbamazepin, Oxcarbazepin und Phenytoin behandelt. Wir haben retrospektiv die Behandlung von 175 JME-Patienten unserer Epilepsieambulanz analysiert. Bei Erstvorstellung in unserer Spezialambulanz wurden 24% (42 von 175) der Patienten mit Natriumkanal-blockierenden AE behandelt, worunter nur ein Patient anfallsfrei war. Nach Umstellung auf zumeist Valproat und Lamotrigin wurden 42% dieser Patienten anfallsfrei. Diese Zahlen betonen die Wichtigkeit der Syndrom-Diagnose und einer adäquaten AE-Wahl in der Behandlung der JME.
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Rémi, J., Stoyke, C. & Noachtar, S. Die juvenile myoklonische Epilepsie wird häufig inadäquat behandelt. Z. Epileptol. 21, 2–5 (2008). https://doi.org/10.1007/s10309-008-0290-4
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DOI: https://doi.org/10.1007/s10309-008-0290-4