Riduzione di terapia nel paziente adulto e anziano con Sindrome di Janz : analisi retrospettiva di una casistica

Juvenile myoclonic epilepsy (JME) is one of the most common types of idiopathic epilepsy that usually appears around puberty. Response to appropriate drugs is good, but therapy has to be continued lifelong because of the high risk of recurrence at drugs withdrawal classically referred in the literature (around 90%). Long term prognosis of this epileptic syndrome in adult and elderly patients is not well known. We studied retrospectively all patients with JME followed in our Epilepsy Centre (n = 130). We found that about half of them tried to withdraw drug treatments: in 46.7% of patients who reduced drug dosage seizure recurred, while 78.3% of patients who completely withdrew drugs relapsed. Family history of epilepsy, age at onse of seizures, sex, presence of photoparoxymal response, epileptiform EEG abnormalities before drug withdrawal, and age at withdrawal were not significantly associated with relapse rate. A high prevalence of drug resistance was found also in patients over 40 and over 50 years of age, suggesting that JME is a lifelong condition, and no reduction of its expression with aging is detectable.