Abstracts

Rationale: Up to 20% of people with juvenile myoclonic epilepsy (JME) do not achieve adequate seizure control despite taking sodium valproate. It is established that people with drug sensitive JME score less well on neuropsychological tests of executive function. We wanted to describe pattern of deficits in drug refractory JME; focussing on what may most affect daily life. Methods: As part of the MRC funded ReJUMeC study a cohort had extended neuropsychological testing including elements from the BADS (n= 31) (Behavioural Assessment of the Dysexecutive Syndrome) and the Eysenck personality questionnaire (n=12). Alongside the main cohort they also had a semi-structured clinical interview and sat the WAIS-III, WMS, DKEFS and the Boston naming test. Results: 12/31 scored in the impaired range on the BADS; those that did were also significantly (p<0.05) impaired on 15/21 other cognitive domains (compared to 4/21 for those who scored in the average or superior range on the BADS). Lower IQ was correlated with a lower BADS score; however not with the zoo map task. The zoo map is an executive function test with good ecological validity, and impairment on this was found to be significantly correlated with having a neurotic personality. Regression analysis revealed no other factors that were significant predictors of impairment on the zoo map. Conclusions: People with drug resistant JME are not only impaired on tests of executive function but across a wide variety of cognitive domains. JME is a heterogeneous disorder: we hypothesise that the subgroups identified by neuropsychological testing will also show differences when studied using advanced imaging and genetic techniques.