Ceska a Slovenska Neurologie a Neurochirurgie, cilt.83, sa.2, ss.180-183, 2020 (SCI-Expanded)
Aim: Juvenile myoclonic epilepsy (JME) is an epilepsy syndrome characterized by myoclonic seizures and good response to treatment. Factors such as sleep deprivation, hunger, stress, bright flashing lights and menstruation may provoke seizures. The objective of this study was to investigate these provocative factors, whether they display changes over time and have a relation to treatment response. Methods: 200 patients with a JME diagnosis who are being followed in our outpatient clinic were included in the study. The demographic and clinical characteristics of the patients were recorded. The provocative factor presence and temporal evolution of these factors were investigated in face-to-face interviews with patients. The patients were categorized into two groups based on treatment response and compared according to the presence and temporal evolution of the provocative factors. Results: 200 JME patients were enrolled and the mean age was 26.77 ± 8.06 (12–49) years. At least one provocative factor was identified in 199 patients (99.5%). The most common provocative factors were sleep deprivation, in 166 (83%), stress in 151 (75.5%) and fatigue in 125 (62.5%) of patients. The response to treatment was less satisfactory in patients with persistent sensitivity to sleep deprivation, stress, fatigue, hunger, photo stimulation and sadness (P < 0.05). Conclusion: Provocative factors may evolve over time, but the persistent presence of seizure-provocative factors in patients with JME may indicate that the treatment response will be less satisfactory. These results show that paying attention to provocative factors is not only helpful for providing means to prevent seizures, but also for predicting the treatment response.