title: Prognosis of juvenile myoclonic epilepsy 45 years after onset: seizure outcome and predictors.
abstract: OBJECTIVE
  Juvenile myoclonic epilepsy (JME) is the most common idiopathic generalized epilepsy subsyndrome, contributing to approximately 3% to 11% of adolescent and adult cases of epilepsy. However, little is known about the long-term medical evolution of this clinical entity. The aim of this study was to analyze long-term outcome in a clinically well-defined series of patients with JME for seizure evolution and predictors of seizure outcome.
  
  
  METHODS
  In this retrospective cohort study, we analyzed seizure outcome in 66 patients who had JME, were treated at the Department of Neurology, Charité-Universitätsmedizin Berlin, and were initially diagnosed by a single senior epileptologist.
  
  
  RESULTS
  After a mean follow-up time of 44.6 years (20-69 years), 59.1% of patients remained free of seizures for at least 5 years before the last contact. Among the seizure-free patients, 28 (71.8%) were still taking antiepileptic drugs and 11 (28.2%) were off medication for at least the last 5 years. We identified manifestation of additional absence seizures at onset of JME as an independent predictor of an unfavorable outcome regarding seizure freedom.
  
  
  CONCLUSIONS
  A significant proportion of patients with JME were seizure-free and off antiepileptic drug therapy in the later course of their disorder. Patients with JME and additional absence seizures might represent a different JME subtype with a worse outcome.
authors.affiliation: From the Department of Psychosomatic Medicine (P.S.), and Epilepsy-Center Berlin-Brandenburg, Department of Neurology (M.H., D.J.), Charité-Universitätsmedizin Berlin; and Center for Epilepsy (B.S.), Department of Neurology, Vivantes-Humboldt Klinikum, Berlin, Germany.
authors.forename: Philine
authors.initials: P
authors.lastname: Senf
authors.forename: Bettina
authors.initials: B
authors.lastname: Schmitz
authors.forename: Martin
authors.initials: M
authors.lastname: Holtkamp
authors.forename: Dieter
authors.initials: D
authors.lastname: Janz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020190:Myoclonic Epilepsy, Juvenile / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000927:Anticonvulsants