Kilic, BetulSerdaroglu, EsraPolat, Burcin GonulluInce, TugceEsenulku, GulnurTopcu, YaseminSerdaroglu, Ayse2023-01-122023-01-1220221059-13111532-2688https://doi.org/10.1016/j.seizure.2022.05.005https://hdl.handle.net/11454/76860Purpose:Valproic acid (VPA) is frequently used and effective in juvenile myoclonic epilepsy (JME). Recently, levetiracetam (LEV) has been suggested as a monotherapy in JME. This study aimed to evaluate antiseizure medication (ASM) use in patients with JME. Methods: Treatment choices in a total of 257 patients (age range 8-18 years, 152 girls, 105 boys) with JME diagnosed and treated between 2010 and 2020 were evaluated retrospectively. Seizure remission was defined as complete seizure control for at least 12 months. Results: Across the study period and entire patient group, VPA was most commonly chosen as the initial ASM (50.9%), followed by LEV (44.4%), and lamotrigine (4.7%). VPA was also the most frequent first choice in the subgroup of boys (73.3%), while LEV was the commonest first choice in girls (57.9%). The sex difference regarding the ASM of the first choice was statistically significant (p<0.001). While VPA was the most frequent initial ASM in the first 5 years of the study period (2010-2015,n = 66, 64%), LEV had taken over as the most popular first ASM in the last 5 years (n = 83, 53.9%, p = 0.005). The most frequent reasons for discontinuation were inefficacy for LEV and adverse effects for VPA (p= 0.001). During follow-up, 237 patients (92.2%) were seizure-free for at least 12 months, and 159 (61.9%) were also in electmgraphic remission. Seizure remission occurred earlier than electroencephalographic remission (p<0.001). Conclusion: This study revealed that LEV has become the most frequently chosen initial ASM in the treatment of JME. Although LEV appears to have a better adverse effect profile, VPA seems more likely to be effective in achieving seizure control.en10.1016/j.seizure.2022.05.005info:eu-repo/semantics/closedAccessjuvenile myoclonic epilepsyvalproic acidlevetiracetamLevetiracetamValproateMonotherapyManagementArticle994853WOS:0008216235000052-s2.0-8513031461735594744Q2Q3