title: Self-perception of factors that precipitate or inhibit seizures in juvenile myoclonic epilepsy.
abstract: OBJECTIVE
  To assess self-perception of factors that precipitate or inhibit seizures in patients with juvenile myoclonic epilepsy (JME).
  
  
  METHODS
  Thirty-six males and 39 females with JME and mean age of 25.8+/-8.7 years were analysed. All patients completed a standardized questionnaire to assess for the presence or absence of precipitant or inhibitory factors for their seizures in a face-to-face interview. These data were statistically analysed through logistic and linear regression models and Phi coefficient.
  
  
  RESULTS
  Ninety-two percent of the patients identified at least one precipitating factor (PF). In order of frequency the following PFs were recorded: stress (83%), sleep deprivation (77%), specific thoughts/mental concentration (23%), performance of hand activities and complex finger movements (20%), flashing lights and playing games (15%), speaking out in public (11%) and alcohol intake (11%), reading (7%), calculating and writing (5%), playing musical instruments (4%), drawing (3%), and specific types of music (1%). Menstrual cycle was the third most important PF in the women (33%). Although PFs were easily recognized, 77% of the patients stated that they were unable to avoid the occurrence of the seizures.
  
  
  CONCLUSIONS
  Structured questionnaire is useful in stimulating patients to self-report seizure precipitants. Patients with higher education and uncontrolled seizures identified them more easily. The presence of a significant number of uncommon PFs, such as mental and motor hand tasks, considered uncommon for other epileptic syndromes, suggests that the role of these factors may be under-recognized in JME.
authors.affiliation: Unidade de Pesquisa e Tratamento das Epilepsias (UNIPETE)-Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Hospital São Paulo, Escola Paulista de Medicina, São Paulo, Brazil.
authors.forename: Patrícia
authors.initials: P
authors.lastname: da Silva Sousa
authors.forename: Katia
authors.initials: K
authors.lastname: Lin
authors.forename: Eliana
authors.initials: E
authors.lastname: Garzon
authors.forename: Américo C
authors.initials: AC
authors.lastname: Sakamoto
authors.forename: Elza Márcia T
authors.initials: EM
authors.lastname: Yacubian
mesh_terms: D000293:Adolescent; D000328:Adult; D003863:Depression / Q000150:complications; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D007407:Interviews as Topic; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D020190:Myoclonic Epilepsy, Juvenile / Q000503:physiopathology* / Q000523:psychology; D015985:Precipitating Factors; D012189:Retrospective Studies; D012307:Risk Factors; D012649:Self Concept; D012737:Sex Factors; D012892:Sleep Deprivation / Q000150:complications; D012917:Social Adjustment; D013315:Stress, Psychological / Q000150:complications; D011795:Surveys and Questionnaires