Evaluation of Risk Factors for Refractory Juvenile Myoclonic Epilepsy

Abstract

Numerous studies have explored treatment-resistant Juvenile Myoclonic Epilepsy (JME), yielding variable results due to differences in study types and locations. JME, being the most prevalent form of generalized convulsions, significantly influences an individual's lifestyle, underscoring the importance of effective seizure control. Despite JME typically responding well to treatment in young individuals, some cases exhibit resistance. While existing literature has investigated reasons for resistance, there is a lack of information specific to our population. Consequently, this study aims to investigate the risk factors associated with treatment-resistant myoclonic epilepsy in young individuals. Materials and Methods: The study included young patients with myoclonic epilepsy resistant to treatment, diagnosed between 2013 and 2023, referred to Tabriz Razi Hospital, with confirmation from a neurologist. A questionnaire, designed by a neurologist, collected information on family history, concomitant psychiatric disorders, patient age and sex, education, drug type, and discontinuation time. This descriptive cross-sectional study was conducted at Tabriz University of Medical Sciences in 2023. Results: Risk factors associated with treatment-resistant epilepsy in myoclonic patients include onset age over 14 years (4.41 times), male gender (6.10 times), average monthly Generalized Tonic-Clonic seizures (12.27 times more than one), duration of uncontrolled epilepsy over one year (8.15 times), parental family ratio (2.59 times), treatment discontinuation for more than 4 years (20.96 times), treatment discontinuation age less than 20 years (15.26 times), concomitant psychiatric diseases (3.85 times), simultaneous Generalized Tonic-Clonic seizures (12.63 times), number of appropriate AEDs more than 2 (25.63 times), frequency of epileptiform waves more than 5 Hz (18.12 times), polyspike more than 3 (11.27 times), amplitude greater than 1 mV (12.23 times), wave length greater than 3 seconds (11.29 times), and simultaneous status (19.52 times)