AI Article Synopsis
- - Juvenile myoclonic epilepsy (JME), or Janz syndrome, is a genetic form of epilepsy that makes up about 10% of all cases and has a significant portion of patients (around 30%) whose seizures resist standard anti-seizure medications.
- - Although valproate (VPA) is a common first-choice treatment, levetiracetam (LEV) is preferred for women of childbearing age, and alternative medications are recommended based on the specific seizure types experienced.
- - For patients with ongoing seizures, different medications like lamotrigine and clonazepam are suggested depending on the kind of seizures, and VPA remains an option for women when other treatments fail, with proper precautions. *
Article Abstract
Introduction: Juvenile myoclonic epilepsy (JME), also known as Janz syndrome, is a common form of generalized epilepsy of presumed genetic origin representing up to 10% of all epilepsy cases. Despite adequate anti-seizure medication (ASM) treatment, seizures persist in one-third of JME patients.
Areas Covered: A literature search was conducted using Pubmed search on the topics of drug-resistant JME.
Expert Opinion: About 30% of JME patients are drug-resistant. Valproate (VPA) is considered the first-choice drug. In women of childbearing potential, levetiracetam (LEV) should represent the first-choice treatment. Alternative monotherapy or add-on therapy should be considered in subjects with resistant seizures after the exclusion of pseudo-drug resistance. The choice of the add-on ASM depends on the predominant seizure type. In subjects with persistent bilateral tonic-clonic seizures, LEV or lamotrigine should be firstly considered. In patients with difficult-to-treat myoclonic seizures, clonazepam or LEV are recommended. In case of persistent absences, ethosuximide should be considered. With appropriate selection and safeguards in place, VPA should remain available as an option in women of childbearing potential whose seizures are resistant to other treatments.
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| http://dx.doi.org/10.1080/14737175.2021.1931126 | DOI Listing |
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