Dados do Trabalho

Título

Type of antiseizure medicine is not related to impulsiveness in patients with juvenile myoclonic epilepsy

Introdução

Juvenile myoclonic epilepsy (JME) is one the most common types of generalized epilepsy, with onset during adolescence and corresponding to 26% of these epilepsies. JME is characterized by seizures that occur within 2 hours of awakening, with myoclonic jerks predominantly in the arms and often without changes in consciousness, frequent tonic-clonic
and rare absence seizures during life.

Objetivo

The main objective of this study was to evaluate differences in impulsiveness, seizure control neuropsychological findings and antiseizure medicines (ASM) in patients with JME.

Método

Age> 17 years; schooling> 10 years and IQ> 69. Impulsiveness was measured by Barratt’s Impulsiveness Scale (BIS-11) and neuropsychological tests: Vocabulary, Cubes, Controlled Oral Word Association (COWA), Digits, Trail Making Test (TMT) A and B, Stroop Test (ST) and Wisconsin Card Sorting Test (WCST). Patients were compared to healthy controls. Neurologic and
psychiatric analysis were retrieved from clinical data. Study was approved by local ethics committee.

Resultados

Patients with JME had higher scores of Total Impulsiveness (p=0.005) and Motor Impulsiveness (p<0.001) on BIS-11. Motor Impulsiveness was associated with worse myoclonic seizures control (p=0.007) and a higher rate of psychiatric disorders (mild anxiety/depression) (p=0.035). When considering ASM used by our patients (Clobazam, Valproate, and Lamotrigine), there were no statistically significant differences in terms of impulsivity rates (p=0.311), or myoclonic seizures control (p=0.831). Also, no differences were observed in impulsiveness of patients who were on therapy with one (p=0.848), two (p=0.805) or three (p=0.236) ASMs. All patients showed impairment in performance of neuropsychological tasks, regardless of the ASM used.

Conclusão

In our study, patients with JME had higher levels of Motor Impulsivity and, consequently, Total Impulsivity, measured by the BIS-11 scale, when compared to controls. Those findings were associated with a higher occurrence of treatment-resistant myoclonic seizures and mild psychiatric disorders. No differences were found between ASMs and levels of impulsiveness, neuropsychological findings or myoclonic seizure control. Being on mono or polytherapy was also not related with levels of impulsiveness or myoclonic seizure control.

Palavras-chave

JME; Impulsiveness; Myoclonic Seizures; Antiseizure Medicine