FAN Zhenyu , LIU Yaqing , DANG Xiaoli , SONG Wenjun , SHI Bei , WU Zhijun , WANG Wenjie , BAI Wenhong , LI Junqiang , WANG Tiancheng
  • Epilepsy Centre, Lanzhou University Second Hospital, Lanzhou 730030, China;
WANG Tiancheng, Email: 814984027@qq.com
Juvenile myoclonic epilepsy; Clinical characteristics; Drug treatment; neuroimaging; First consultation hospital
10.7507/2096-0247.20210049
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Objective To explore the clinical characteristics, neuroimaging, diagnosis and treatment process of inpatients with Juvenile Myoclonic Epilepsy (JME).Methods 83 inpatients with JME in the Epilepsy Center of Lanzhou University Second Hospital from January 2016 to August 2020 were analyzed retrospectively. Their clinical features, seizure types, inducing factors, MRI and EEG, first consultation hospital, reason for visit and drug treatment were summarized.Results Among the 83 patients, there were 43 males and 40 females, with an average age of (18±5.6) years. 21 patients had family history of epilepsy or history of febrile convulsion. the average age of onset was 11.5 years old, which was earlier than those without family history and history of febrile convulsion (P<0.05). The results of cranial nuclear magnetic resonance examination were abnormal in 14 patients, including hippocampal sclerosis and local small cysts. The first symptom of 62.7% JME patients is myoclonic seizures, followed by tonic-clonic seizures, sleep deprivation was the most common inducing factor, and tonic-clonic seizures was the most common cause of treatment in JME patients, accounting for 78.3%. 80.7% of patients choose local primary hospitals for their first consultation, and there was a non-standard use of ASMs in treatment, and the seizure free rate of epilepsy after ASMs treatment was 6%, which was lower than that in provincial hospitals (P<0.05). 88% of JME inpatients can effectively control their seizures through monotherapy, among which valproic acid is the most commonly used monotherapy and combination therapy. The new oral ASMs lamotrigine and levetiracetam tablets were mostly used in female patients.Conclusion A family history of epilepsy and history of febrile convulsion may be associated with an earlier age of onset in patients with JME. Neuroimaging abnormalities can be found in a small number of patients with JME, including hippocampal sclerosis and local small cysts. Tonic-clonic seizures is the main treatment cause of JME patients, and most of them are first diagnosed in local hospitals, but the seizure free rate of epilepsy in local hospitals after ASMs treatment is low, so the training of epilepsy related knowledge for doctors in primary hospitals is helpful to the diagnosis of clinical JME and improve its control rate.

Citation： FAN Zhenyu, LIU Yaqing, DANG Xiaoli, SONG Wenjun, SHI Bei, WU Zhijun, WANG Wenjie, BAI Wenhong, LI Junqiang, WANG Tiancheng. Analysis of clinical characteristics, neuroimaging, diagnosis and treatment process of inpatients with juvenile myoclonic epilepsy. Journal of Epilepsy, 2021, 7(4): 309-313. doi: 10.7507/2096-0247.20210049 Copy

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