Prognosis of Juvenile myoclonic epilepsy with eye-closure sensitivity
Prognosis of Juvenile myoclonic epilepsy with eye-closure sensitivity
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DOI：
10.1016/j.seizure.2018.09.006
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发表时间：
2018-11-01
影响因子：
3
通讯作者：
Targas Yacubian, Elza Marcia
中科院分区：
文献类型：
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作者：
Pedroso Uchida, Carina Goncalves;de Carvalho, Kelly Cristina;Targas Yacubian, Elza Marcia
目的：闭眼敏感性（ECS）是青少年肌阵挛性癫痫（JME）的一种反射特征。然而，关于其预后的意义还没有达成共识。本研究的目的是澄清ECS的长期影响记录的临床访谈和视频脑电图神经心理学协议（VNPP）在一系列的133 JME patients.Methods：数据从22 JME患者证实ECS的VNPP（组1）与20 JME患者没有任何反射性状（组2）进行了比较。平均随访时间为8.21年（SD = +/- 5.044）。使用日记评估癫痫发作的频率。除了光敏性（PS），任何其他反射性状的发生，药物/酒精滥用的摄入量，不遵守，和Jeavons综合征，被认为是排除criterions.Results：组1有较低的年龄在癫痫发作（p = 0.028），较高的发病率热性惊厥（13.6%），和癫痫家族史（p = 0.023）。只有18.2%的患者有眼睑肌阵挛（EM）的自我感觉（Kappa系数= 0.193），77.3%的患者持续存在。第1组中肢体肌阵挛、强直-阵挛性癫痫发作（TCS）和/或肌阵挛-强直-阵挛性癫痫发作（MTCS）以及失神更常见（分别为p = 0.015; p = 0.013; p = 0.011）。PS不影响EM（p = 1.0）、缺勤（p = 0.648）或TCS/MTCS（p = 0.934）的频率。精神共病组之间没有不同groups.Conclusions：ECS是一个更糟糕的结果控制所有癫痫发作类型，持久性EM，和更高的频率肢体肌阵挛，以及TCS和/或MTCS的总数。
Purpose: Eye closure sensitivity (ECS) has been described as a reflex trait in juvenile myoclonic epilepsy (JME). However, there is no consensus regarding its significance on prognosis. The aim of this study is to clarify the long-term impact of ECS documented by a clinical interview and a video-EEG neuropsychological protocol (VNPP) in a series of 133 JME patients.Methods: Data from 22 JME patients with ECS confirmed by a VNPP (Group 1) were compared with those of 20 JME patients without any reflex traits (Group 2). They were followed for a mean of 8.21 years (SD = +/- 5.044). The frequency of seizures was assessed using a diary. Except for photosensitivity (PS), any other reflex traits occurrence, drugs/alcohol abuse intake, noncompliance, and Jeavons syndrome, were considered exclusion criteria.Results: Group 1 had a lower age at epilepsy onset (p = 0.028), higher incidence of febrile seizures (13.6%), and familial history of epilepsy (p = 0.023). Only 18.2% had self-perception of eyelid myoclonia (EM) (kappa coefficient = 0.193), which persisted in 77.3% of patients. Limb myoclonia, tonic-clonic seizures (TCS) and/or myoclonic-tonic-clonic seizures (MTCS), as well as absences were more frequent (p = 0.015; p = 0.013; p = 0.011, respectively) in Group 1. PS did not influenced frequency of EM (p = 1.0), absences (p = 0.648), or TCS/MTCS (p = 0.934). Psychiatric comorbidities were not different between groups.Conclusions: ECS is related to a worse outcome regarding control of all seizure types, persistence of EM, and higher frequency of limb myoclonia, as well as the total number of TCS and/or MTCS.