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

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 committ...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2023-09, Vol.64 (9), p.2342-2350
Main Authors: Smith, Kelsey M, Wirrell, Elaine C, Andrade, Danielle M, Choi, Hyunmi, Trenité, Dorothée Kasteleijn-Nolst, Jones, Hannah, Knupp, Kelly G, Mugar, Jon, Nordli, Jr, Douglas R, Riva, Antonella, Stern, John M, Striano, Pasquale, Thiele, Elizabeth A, Zawar, Ifrah
Format: Article
Language:English
Subjects:
Caregivers
Disease management
Epilepsy
Etiracetam
Eyelid
Lamotrigine
Nutrition therapy
Patients
Remission
Seizures
Valproic acid
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Summary: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
ISSN:0013-9580
1528-1167
DOI:10.1111/epi.17682