Investigators at Epilepsy Centers in Berlin, Germany, performed a retrospective study of seizure outcome in 66 patients with juvenile myoclonic epilepsy (JME) after a mean follow-up time of 44.6 years (20-69 years); 59.1% of patients remained seizure-free for at least 5 years before the last contact. Of seizure-free patients, 28 (71.8%) remained on AEDs and 11 (28.2%) were off medication for at least the last 5 years. Absence seizures at onset were an independent predictor of an unfavorable outcome and JME persistence. [1]
COMMENTARY. JME is usually described as a chronic disorder requiring lifelong therapy [2]. In contrast, recent long-term follow-up studies point to a more favorable prognosis, allowing cautious withdrawal of medication after long seizure control [3]. In an editorial comment, a trial of older medications, including primidone and acetazolamide, is recommended in patients with refractory JME [4].