title: Evolution of juvenile myoclonic epilepsy treated from the outset with sodium valproate.
abstract: Sodium valproate (VPA) is considered the first choice drug in juvenile myoclonic epilepsy (JME). We have analysed the long-term evolution of 22 patients treated from the outset with VPA. The following inclusion criteria were applied: (1) unequivocal diagnosis of JME; (2) treatment should be initiated with VPA monotherapy; and (3) follow-up for more than 5 years. Twenty-two patients (15 females, seven males) were studied and their EEG recordings were analysed. Their mean age was 28 years (range: 20-40 years) and their mean follow-up was 7.7 years (range: 5-17 years). Four of them suffered persistent seizures despite optimal VPA dosage and needed the addition of a second drug (lamotrigine in three cases, clobazam in one case). All of our patients who continued their treatment are seizure-free. VPA effectively controlled all seizures in 80% of patients. The discontinuation of drug therapy lead to a very high rate of relapses. With accurate diagnosis and appropriate therapy, seizures in JME can be effectively controlled. VPA is a very effective antiepileptic drug in controlling the seizures of JME, but many patients relapse after VPA discontinuation. Thus, JME may require lifelong therapy.
authors.affiliation: Neurological Department, Hospital General de Asturias, Oviedo, Spain. jsalasp@meditex.es
authors.forename: S
authors.initials: S
authors.lastname: Calleja
authors.forename: J
authors.initials: J
authors.lastname: Salas-Puig
authors.forename: R
authors.initials: R
authors.lastname: Ribacoba
authors.forename: C H
authors.initials: CH
authors.lastname: Lahoz
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020190:Myoclonic Epilepsy, Juvenile / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D014635:Valproic Acid / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid