All patients developing juvenile myoclonic epilepsy (JME) by 16 years of age in Nova Scotia between 1977 and 1985 were contacted in 2006-2008 to determine long-term seizure and social outcome, in a study at Dalhousie University, Halifax, Canada. Of 24 patients (17 women) with JME, 23 were contacted at a mean age of 36 +/- 4.8 years. Age at first seizure was 10.4 +/- 4.3 years. At 25-year follow-up, 11 (48%) had discontinued AED treatment: 6 were seizure-free (without AEDs) for 5-23 years, 3 had only myoclonic seizures, and 2 had rare seizures. Of those with continued seizures, 8 (36%) had episodes of convulsive status epilepticus, and 3 had intractable epilepsy. Seventy percent enjoyed satisfactory health, work, friendships, and social life, 87% graduated high school, and 69% were employed. Nine were taking antidepressants. Ten women had been pregnant and 4 men were fathers. Eleven pregnancies (80%) were unplanned, and at least 1 unfavorable social outcome was noted in 76%. 
COMMENT. One-third patients with JME at 25-year follow-up have seizures well controlled and AED discontinued, in contrast to the generally poor seizure outcome in previous reports. Three-quarters have experienced at least one major unfavorable social event, but 70% report satisfaction with their social life.