Juvenile myoclonic epilepsy
Overview
A form of epilepsy that occurs in teenagers and involves sudden muscle jerking and seizures which is especially common on awakening.
Symptoms
- Myoclonic jerk
- Epileptic seizures
Causes
In about one-half of all epilepsy cases, the cause is unknown. Possible causes include:
- birth trauma (inadequate oxygen supply to the brain, blood incompatibility, or hemorrhage)
- perinatal infection
- anoxia
- infectious diseases (meningitis, encephalitis, or brain abscess)
- ingestion of toxins (mercury, lead, or carbon monoxide)
- brain tumors
- inherited disorders or degenerative disease, such as phenylketonuria or tuberous sclerosis
- head injury or trauma
- metabolic disorders, such as hypoglycemia and hypoparathyroidism
- stroke (hemorrhage, thrombosis, or embolism).
Diagnosis
Diagnosis is typically made based on patient history. EEG recordings are also sometimes used as confirmation.
Treatment
Generally, treatment of epilepsy consists of anticonvulsant therapy to reduce the number of future seizures. The most commonly prescribed drugs include phenytoin, carbamazepine, phenobarbital, gabapentin, or primidone administered individually for generalized tonic-clonic seizures and complex partial seizures. Valproic acid, clonazepam, and ethosuximide are commonly prescribed for absence seizures. Gabapentin and felbamate are also anticonvulsant drugs. A patient taking anticonvulsant medications requires monitoring for toxic signs: nystagmus, ataxia, lethargy, dizziness, drowsiness, slurred speech, irritability, nausea, and vomiting. If drug therapy fails, treatment may include surgical removal of a demonstrated focal lesion to attempt to stop seizures. Emergency treatment of status epilepticus usually consists of diazepam (or lorazepam), phenytoin, or phenobarbital; dextrose 50% I.V. (when seizures are secondary to hypoglycemia); and thiamine I.V. (in chronic alcoholism or withdrawal).