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Determination of the factors that cause valproic acid resistance in the pediatric juvenile myoclonic epilepsy cohort

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Abstract

Juvenile myoclonic epilepsy (JME) has an approximate prevalence of 18%–20% among idiopathic generalized epilepsy types. Valproic acid (VPA) is the first line treatment of JME; however, resistance to VPA was detected as the most important prognostic entity for refractory seizures. The present study aims to determine the factors that induce VPA resistance in pediatric patients with JME. Patients between the ages of 10 and 18 who were diagnosed with JME were examined retrospectively. The groups with VPA resistant and non-resistant group were statistically analyzed. Total of 62 patients diagnosed with JME, 41 (66.1%) of them were female. The average age was 15.48±2.11 years. VPA resistance was detected in 21(33.8%) of our patients. Seizure onset age of patients younger than 15 years, presence of febrile seizure (FS), photosensitivity, seizure type, seizures occurring both at day and night, and epileptic discharge longer than 3 seconds during EEG were found to be statistically significant risk factors for the development of VPA resistance. Close monitoring of individuals with these risk factors is recommended for VPA resistance.

Key words: Juvenile myoclonic epilepsy, EEG, Valproic acid resistance, treatment






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