Management of epilepsy with eyelid myoclonia: Results of an international expert consensus panel.


Journal

Epilepsia
ISSN: 1528-1167
Titre abrégé: Epilepsia
Pays: United States
ID NLM: 2983306R

Informations de publication

Date de publication:
09 2023
Historique:
revised: 24 05 2023
received: 28 04 2023
accepted: 13 06 2023
medline: 20 9 2023
pubmed: 16 6 2023
entrez: 16 6 2023
Statut: ppublish

Résumé

There are limited data about the treatment and management of epilepsy with eyelid myoclonia (EEM). The objective of this study was to determine areas of consensus among an international panel of experts for the management of EEM (formerly known as Jeavons syndrome). An international steering committee was convened of physicians and patients/caregivers with expertise in EEM. This committee summarized the current literature and identified an international panel of experts (comprising 25 physicians and five patients/caregivers). This panel participated in a modified Delphi process, including three rounds of surveys to determine areas of consensus for the treatment, other areas of management, and prognosis for EEM. There was a strong consensus for valproic acid as the first-line treatment, with levetiracetam or lamotrigine as preferable alternatives for women of childbearing age. There was a moderate consensus that ethosuximide and clobazam are also efficacious. There was a strong consensus to avoid sodium channel-blocking medications, except for lamotrigine, as they may worsen seizure control. There was consensus that seizures typically persist into adulthood, with remission occurring in <50% of patients. There was less agreement about other areas of management, including dietary therapy, lens therapy, candidacy for driving, and outcome. This international expert panel identified multiple areas of consensus regarding the optimal management of EEM. These areas of consensus may inform clinical practice to improve the management of EEM. In addition, multiple areas with less agreement were identified, which highlight topics for further research.

Identifiants

pubmed: 37326215
doi: 10.1111/epi.17682
doi:

Substances chimiques

Lamotrigine U3H27498KS
Anticonvulsants 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2342-2350

Informations de copyright

© 2023 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.

Références

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Auteurs

Kelsey M Smith (KM)

Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.

Elaine C Wirrell (EC)

Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.

Danielle M Andrade (DM)

Department of Neurology, University of Toronto, Toronto, Ontario, Canada.

Hyunmi Choi (H)

Department of Neurology, Columbia University, New York, New York, USA.

Dorothée Kasteleijn-Nolst Trenité (DK)

Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands.

Hannah Jones (H)

Chicago, Illinois, USA.

Kelly G Knupp (KG)

Department of Pediatrics, University of Colorado, Aurora, Colorado, USA.

Jon Mugar (J)

Boston, Massachusetts, USA.

Douglas R Nordli (DR)

Department of Neurology, University of Chicago, Chicago, Illinois, USA.

Antonella Riva (A)

L'Istituto di Ricovero e Cura a Carattere Scientifico Istituto Giannina Gaslini, Genoa, Italy.
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Genoa, Italy.

John M Stern (JM)

Department of Neurology, University of California, Los Angeles, Los Angeles, California, USA.

Pasquale Striano (P)

L'Istituto di Ricovero e Cura a Carattere Scientifico Istituto Giannina Gaslini, Genoa, Italy.
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Genoa, Italy.

Elizabeth A Thiele (EA)

Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.

Ifrah Zawar (I)

Department of Neurology, University of Virginia, Charlottesville, Virginia, USA.

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