Predictive factors of higher drug load for seizure freedom in idiopathic generalized epilepsy: Comparison between juvenile myoclonic epilepsy and other types

Purpose: Predictive factors of higher drug load for seizure freedom were investigated in idiopathic generalized epilepsy (IGE), focusing on the difference between juvenile myoclonic epilepsy (JME) and other types of IGE (non-JME IGE). Methods: Twelve patients with JME and 12 patients with non-JME IGE, who achieved seizure freedom for 1 year or longer with appropriate antiepileptic drugs (AEDs) after video electroencephalography monitoring, were reviewed retrospectively. The sum of prescribed daily dose/defined daily dose ratio of all prescribed AEDs at the final visit was defined as total AED load. Patients requiring total AED load >1 were classified into the higher AED load group. Clinical background and the presence of interictal focal epileptiform abnormalities (FEAs) were compared between the higher and lower AED load groups. Results: Higher AED load group of patients with JME had interictal FEAs and family history of epilepsy more frequently than the lower AED load group (p = 0.03 and p = 0.03). Similar comparison of patients with non-JME IGE showed no significant differences. Conclusions: The presence of interictal FEAs and a family history of epilepsy are significantly associated variables for higher AED load for seizure freedom in patients with JME, but not in patients with non-JME IGE.