Abstracts

Rationale: The long-term seizure and social outcome in juvenile myoclonic epilepsy (JME) is still controversial. The aim of this study was to investigate the long-term social outcome in relation to the seizure outcome in JME patients with a follow-up of at least 25 years. Methods: Data from 31 patients (19 women) diagnosed with JME and at least 25 years of follow-up (mean 39.1 years) were studied. All of them were re-evaluated with a review of their medial records and a face-to-face or direct telephone interview. Quality of life was assessed using the QOLIE-10 questionaire (Quality Of Life In Epilepsy). Results: Of 31 patients, 21 (67.7%) became seizure-free, 6 of them (28.6%) without antiepileptic drug (AED) treatment. All patients with continuing seizures were in special medical attendance with epileptologists. The lack of factors that potentially provoke seizures, such as alcohol consumption (p = 0.015) and sleep deprivation (p = 0.067), was found to be associated with a worse seizure outcome; ongoing AED treatment associates with early retirement (p = 0.002) and long-term unemployment (p = 0.071). Although not significant, successful treatment decreases the chance for unemployment (17.6% vs. 55.6%) and family instability (divorce rate 14.3% vs. 30%) and increases the chance for a healthier lifestyle (smoking 28.6% vs. 50%, sleep disturbances 30% vs. 50%). Epilepsy-related quality of life was significantly higher in seizure-free patients (p = 0.001). Conclusions: Our study provides statistical validation that the social situation in JME patients essentially depends on the long-term seizure outcome. Successful treatment decreases the chance of unemployment and social isolation, and significantly increases the quality of life. Special medical attendence with epileptologists or specialized neurologists was shown to be essential in the treatment of patients with JME.