Abstract Details

Title The Neuropsychiatric Burden in Juvenile Myoclonic Epilepsy: How Comorbidities Influence Treatment Response — Experience from a Tertiary Referral Center in LATAM

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P6 - Poster Session 6 (5:00 PM-6:00 PM)

Poster/Presentation
Number 10-009

Objective To explore the association between psychiatric comorbidities and the number of antiseizure medications (ASMs) in patients with juvenile myoclonic epilepsy (JME), and to evaluate whether these comorbidities increase the likelihood of requiring polytherapy and reduce seizure freedom.

Background Juvenile myoclonic epilepsy (JME) represents between 5-10% of all epilepsies and close to 18% of the idiopathic generalized epilepsies, with a prevalence of approximately 1/1,000 persons. It is characterized by myoclonus, generalized tonic-clonic seizures and absences. Although SANAD II determined that valproic acid is usually effective, the presence of psychiatric comorbidities can compromise the therapeutic response and promote drug resistance.

Design/Methods We conducted a cross-sectional study of 145 patients with JME evaluated at the National Institute of Neurology and Neurosurgery. Clinical and demographic features, seizure types, ASM regimens, and psychiatric comorbidities diagnosed under DSM-5 criteria were recorded. Seizure freedom was defined as absence of any seizure type for ≥12 months. Associations between psychiatric burden, ASM number, and seizure control were analyzed using chi-square tests, ordinal correlations, and multivariable comparisons adjusted for key demographic and clinical covariates (p < 0.05).

Results Among 145 participants (Mean age 28 ± 8 years), 58% (n=84) had at least one psychiatric comorbidity. Depression and personality disorders were significantly associated with lower seizure freedom (Global p = 0.019) and higher ASM load (r = 0.19, p = 0.024). Increasing number of ASMs inversely correlated with seizure control across seizure types (p ≤ 0.002).

Conclusions Psychiatric comorbidities, particularly depression, emerge as core correlates of treatment resistance in JME. Higher pharmacologic load mirrors both disease severity and psychiatric burden, suggesting that neuropsychiatric mechanisms may perpetuate drug refractoriness. These findings are complemented by a parallel analysis from the same JME cohort exploring the bidirectional relationship between depression and seizure freedom (“The Neuropsychiatric Loop in JME”).

Authors/Disclosures
Juan C. Vera, Jr., Medical Student PRESENTER	Dr. Vera has nothing to disclose.
Stefan Narvaez-Labuhn, Medical Student	Mr. Narvaez-Labuhn has nothing to disclose.
Maximiliano D. Salgado Deza	Maximiliano D. Salgado Deza has nothing to disclose.
Fernando Vasquez Lopez, MD	Dr. Vasquez Lopez has nothing to disclose.
Salvador Martinez-Medina, MD	Dr. Martinez-Medina has nothing to disclose.
Katherin M. Plasencia Correa, MD	Dr. Plasencia Correa has nothing to disclose.
Mariana Peschard Franco (Medica Sur)	Mrs. Peschard Franco has nothing to disclose.
Andres Felipe Morcillo Muñoz, Sr., MD	Dr. Morcillo Muñoz has nothing to disclose.
Mario Sebastian-Diaz, MD, PhD	Dr. Sebastian-Diaz has nothing to disclose.
Iris E. Martinez-Juarez, MD (Instituto Nacional de Neurología y Neurocirugía)	No disclosure on file

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