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Yıl:1999; Cilt: 36; Sayı: 3>> Özet
Nöropsikiyatri Arşivi; 1999;36(3):123-127
Juvenil myoklonik epilepside uzun süreli izlem bulguları
A Öztürk, B Baykan, C Gürses, A Gökyiğit
İ. Ü. İstanbul Tıp Fakültesi, Nöroloji Anabilim Dalı
Bu çalışmada en az 7 yıl süreyle epilepsi polikliniği­mizden juvenil miyoklonlk epilepsi tanısıyla izlenen 51 hastada klinik seyir özellikleri ve EEG bulguları arasındaki ilişki değerlendirilmiştir. 26 kadın ve 25 erkek hastadan oluşan grupta nöbetlerin başlangıç yaşı 13 ± 2.4 idi. İzlem süreleri 11.3 ± 4 yıl olan has­taların bu süreç içinde %73'ünün kontrol aralığının giderek uzadığı dikkat çekti. İyi seyirli olarak grupla-nan 34 olgu son iki yıl içinde hiç jeneralize tonik klo-nik konvülziyon (JTK) geçilmemişti. Orta seyirli ola­rak tanımlanan 7 hasta yılda 2'den az JTK veya ay­da 2'den az miyoklonik geçirmişti. Kötü prognoz ola­rak isimlendirilen gruptaki 10 hasta ise yılda en az 2 JTK ya da ayda 2 kezden fazla miyokloni belirtmek­teydi. İlk EEG bulgularının prognoz grupları ile iliş­kili olmadığı görüldü. Ancak iyi seyirli grupta ilk EEG'lerinde tipik 4-5 Hz dalga diken deşarjları olan hastaların uzun bir aradan sonra tedavi altında tek­rarlanan EEGlerinde normale dönme oranı anlamlı bulundu. Sonuç olarak JME'de uzun süreli progno-zun Özellikle kronik tedaviye uyum güçlükleri nede­niyle sanıldığı kadar iyi olmadığı ve EEG bulgularının prognozu belirleyici olmadığı görüldü
Longitudinal Term Follow Up In Juvenile Myoclonic Epilepsy
In this study we investigated the relation between EEG findings and the clinical course of 51 epileptic patients followed up at least 7 [year]s with a diagnosis of juvenile myoclonic epilepsy. The average age at the onset of the seizures was 13 ± 2.4 in the group for­med by 26 female and 25 male patients. It has been determined that the admission intervals to the clinic was gradually widening in %73 of the patients with a mean follow-up of 11.3 ± 4 [year]s. Thirty four patients grouped as good course had not experienced genera­lized tonic clonic seizures (GTCs) or myoclonus in last two [year]s. Seven patients were identified as medium course had got GTCs less than two in a [year] and /or got myoclonus more than 2 in a [month]. Ten patients were categorized as bad prognosis, who had got two GTCs or more m a [year] and got myoclonus more than once in a [month]. There was no relationship shown between the first EEG findings and the prognosis of the disease. It was found to be significant that, in the group with "good course", the typical EEG findings of 4-5 Hz spike-wave discharges in the beginning disap­peared after a longitudinal interval and therapy. We found longitudinal term prognosis was not as good as known. Because of difficulties especially to adjust chronic treatment. Additionally, EEG findings had no relationship with the prognosis.

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