From the FDA Drug Label
The effectiveness of levetiracetam as adjunctive therapy (added to other antiepileptic drugs)in patients 6 years of age and older with idiopathic generalized epilepsy experiencing primary generalized tonic-clonic (PGTC) seizures was established in one multicenter, randomized, double-blind placebo-controlled study, conducted at 50 sites in 8 countries Eligible patients on a stable dose of 1 or 2 antiepileptic drugs (AEDs) experiencing at least 3 PGTC seizures during the 8-week combined baseline period (at least one PGTC seizure during the 4 weeks prior to the prospective baseline period and at least one PGTC seizure during the 4-week prospective baseline period) were randomized to either levetiracetam or placebo The population included 164 patients (levetiracetam N=80, placebo N=84) with idiopathic generalized epilepsy (predominately juvenile myoclonic epilepsy, juvenile absence epilepsy, childhood absence epilepsy, or epilepsy with Grand Mal seizures on awakening) experiencing primary generalized tonic-clonic seizures Table 6: Median Percent Reduction From Baseline In PGTC Seizure Frequency Per Week Placebo(N=84)Levetiracetam(N=78) * statistically significant versus placebo Percent reduction in PGTC seizure frequency44.6%77. 6%*
The prognosis for Juvenile Myoclonic Epilepsy (JME) with tonic-clonic seizures is not directly stated in the provided text. However, the study shows that levetiracetam is effective as an adjunctive therapy in reducing the frequency of primary generalized tonic-clonic (PGTC) seizures in patients with idiopathic generalized epilepsy, which includes JME.
- Key points:
- Levetiracetam reduced PGTC seizure frequency by 77.6% compared to 44.6% for placebo.
- The study included patients with JME experiencing PGTC seizures.
- The results suggest that levetiracetam may be effective in reducing tonic-clonic seizures in patients with JME. However, the text does not provide a direct prognosis for JME with tonic-clonic seizures. 1
From the Research
The prognosis for Juvenile Myoclonic Epilepsy (JME) with tonic-clonic seizures is generally favorable with appropriate treatment, with about 62% of patients achieving seizure freedom for over a year, as reported in the most recent study 2.
Key Points
- The most recent and highest quality study, published in 2019, found that approximately 35% of individuals with JME were refractory to treatment, highlighting the importance of early and effective management 3.
- Valproate is often the most effective treatment for JME, but its use should be carefully considered in women of childbearing potential due to teratogenicity risks.
- Other antiepileptic drugs, such as lamotrigine and levetiracetam, may also be effective in controlling seizures.
- Seizure triggers, including sleep deprivation, alcohol consumption, stress, and flickering lights, should be avoided to minimize the risk of seizure recurrence.
- Regular follow-up with a neurologist is essential to monitor medication effectiveness and side effects.
Treatment and Management
- Treatment should be individualized and based on the specific needs and circumstances of each patient.
- The goal of treatment is to achieve complete seizure control, but this may not always be possible.
- Medication should be continued indefinitely, as seizures typically recur when medication is discontinued, even after years of seizure freedom.
- Patients with JME should be counseled about the risks and benefits of treatment, as well as the potential for refractoriness to treatment.
Prognosis
- The prognosis for JME is generally favorable, with most patients achieving good seizure control with appropriate treatment.
- However, about 10-20% of patients may achieve complete remission, allowing for medication withdrawal.
- The presence of certain risk factors, such as absence seizures, psychiatric comorbidities, and earlier age at seizure onset, may be associated with a poorer prognosis 3.