Juvenile Myoclonic Epilepsy

Patient/Family Story

I have always had these little jerks, ever since I was 12 or 13 years old, but I assumed everybody had them. They never really bothered me until one day I had a big one and fell down. I had a couple of grand mal seizures and was put on medication for a few years, and then the drugs were stopped. During college, whenever I stayed up all night or drank too much, the next day I would get lots of those jerks, and sometimes a big seizure right after the jerks. I never thought much of those jerks; in fact, my wife, who doesn't have epilepsy, gets them sometimes as she is falling asleep.

What is Juvenile Myoclonic Epilepsy?

Juvenile myoclonic epilepsy (JME) accounts for about 7% of the cases of epilepsy, making it one of the most common epilepsy syndromes. The syndrome is defined by myoclonic seizures (jerks) with or without tonic-clonic or absence seizures. The EEG usually shows a pattern of intermittent spike-and-wave or polyspike-and-wave, even in between seizures. CT and MRI scans of the brain are normal and typically are not needed.

Seizures usually begin shortly before or after puberty, or sometimes in early adulthood. They usually occur in the early morning, within a couple hours of awakening. Persons with JME often have photosensitive myoclonic seizures in addition to spontaneous seizures. The intellectual functions of persons with JME are the same as those in the general population.

Is Juvenile Myoclonic Epilepsy Inherited?

This syndrome often has a genetic basis. In some families, genes associated with an increased risk of JME are located on chromosomes 6, 8, or 15. The chance that a child born to a parent with JME will also have JME is about 15%.

How is Juvenile Myoclonic Epilepsy Treated?

In most cases, the seizures are well controlled with medication, but the disorder is lifelong. Valproate is the treatment of choice. Other options include lamotrigine, levetiracetam, or topiramate. Carbamazepine may actually worsen the myoclonic jerks.