Ocena zdolności motorycznych dłoni i szybkości ruchu u dzieci i młodzieży z padaczką mioklonią wieku młodzieńczego

OBJECTIVE: In this study, we evaluated the fine motor functions of children and adolescents diagnosed with juvenile myoclonic epilepsy (JME) and compared them with those of a healthy control group. Our aim was to determine whether fine motor performance is affected in the early stages of JME, to identify the factors contributing to these impairments, and to highlight potential areas for early intervention and prevention. METHODS: 47 patients with JME based on clinical history and electroencephalographic findings (mean age 14.43 ± 1.36) and 42 healthy control participants (mean age 14.19 ± 1.54) were included in our study. In the JME group, there were 72.5% females and 27.5% males, while in the control group there were 57.6% females and 42.4% males. Fine motor performance was evaluated using the 9-Hole Peg Test (9HPT), a validated and widely used measure of finger dexterity and hand-eye coordination. The test was administered under standardized conditions to both the juvenile myoclonic epilepsy (JME) group and the age- and sex-matched healthy control group. Each participant completed the test with both the dominant and non-dominant hand, and completion times were recorded for comparative analysis. The patients' clinical, laboratory, radiological and electroencephalographic data, as well as their antiseizure medications (ASMs) use, treatment compliance were recorded and collected through hospital database system (HBS) during the outpatient clinic visits. RESULTS: The dominant-hand 9-Hole Peg Test (9-HPT) scores were 14.55 ± 2.88 seconds in the control group and 17.44 ± 3.53 seconds in the patient group. Similarly, the non-dominant hand 9-HPT scores were calculated as 16.61 ± 2.55 seconds in controls and 19.74 ± 3.60 seconds in patients. The differences in both dominant and non-dominant hand 9-HPT performance were highly statistically significant (p = 0.001). Patients with uncontrolled seizures had significantly higher dominant and non-dominant M-holl 9 scores compared to those under control (Dominant hand: 20.23 ± 2.87 vs. 16.62 ± 3.30, p = 0.005; Non-dominant hand: 22.56 ± 3.09 vs. 18.91 ± 3.34, p = 0.006). Among ASMs subgroups, the lowest dominant-hand 9-HPT score was observed in the VPA group (16.13 ± 3.90), whereas the highest was detected in the MIX group (19.74 ± 3.18), without statistical significance (p = 0.083). For non-dominant-hand performance, the lowest mean score was identified in the LEV group (18.61 ± 3.95) and the highest in the MIX group (22.46 ± 3.00), with a significant intergroup difference (p = 0.045). CONCLUSIONS: Adolescents with JME showed impaired fine motor performance, particularly in patients with uncontrolled seizures and combination ASMs therapy. The 9-HPT may be a useful simple tool for assessing motor dysfunction in JME.