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<front>
<journal-meta>
<journal-id journal-id-type="issn">1043-3155</journal-id>
<journal-id journal-id-type="nlm-ta">Pediatr Neurol Briefs</journal-id>
<journal-id journal-id-type="pmc">pedneurbriefs</journal-id>
<journal-id journal-id-type="iso-abbrev">Pediatr Neurol Briefs</journal-id>
<journal-title-group>
<journal-title>Pediatric Neurology Briefs</journal-title>
<abbrev-journal-title>Pediatr Neurol Briefs</abbrev-journal-title>
</journal-title-group>
<issn pub-type="epub">2166-6482</issn>
<issn pub-type="ppub">1043-3155</issn>
<issn-l>2166-3155</issn-l>
<publisher>
<publisher-name>Pediatric Neurology Briefs Publishers</publisher-name>
<publisher-loc>Chicago, IL, USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">PNB-7-46</article-id>
<article-id pub-id-type="doi">10.15844/pedneurbriefs-7-6-8</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Seizure Disorders</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v2">
<subject>Neurology</subject>
<subject>Pediatrics</subject>
<subject>Nervous System Diseases</subject>
<subject>Child Development</subject>
<subject>Brain Diseases</subject>
<subject>Neurosurgery</subject>
<subject>Child</subject>
<subject>Infant</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Juvenile Myoclonic Epilepsy</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-0173-7931</contrib-id>
<name>
<surname>Millichap</surname>
<given-names>J. Gordon</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
<xref ref-type="aff" rid="AF0002">2</xref>
<xref ref-type="corresp" rid="cor1">&#x002A;</xref>
</contrib>
</contrib-group>
<aff id="AF0001">
<label>1</label>Division of Neurology, Children&#x0027;s Memorial Hospital, Chicago, IL</aff>
<aff id="AF0002">
<label>2</label>Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL</aff>
<author-notes>
<corresp id="cor1"><label>&#x002A;</label>Correspondence: Dr. J. Gordon Millichap, E-mail: <email xlink:href="jgmillichap@northwestern.edu">jgmillichap@northwestern.edu</email>
</corresp>
</author-notes>
<pub-date date-type="pub" publication-format="print">
<month>06</month>
<year>1993</year>
</pub-date>
<pub-date date-type="pub" publication-format="electronic">
<day>01</day>
<month>07</month>
<year>2016</year>
</pub-date>
<volume>7</volume>
<issue>6</issue>
<fpage>46</fpage>
<lpage>47</lpage>
<permissions>
<copyright-statement>Copyright: &#x00A9; 1993 The Author(s)</copyright-statement>
<copyright-year>1993</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/">
<license-p>This work is licensed under the <uri xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution 4.0 International License</uri>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<related-article id="R1" related-article-type="commentary-article" ext-link-type="doi" xlink:href="10.1001/archneur.1993.00540060034013" vol="50" page="594">
<article-title>Juvenile myoclonic epilepsy. A review</article-title>
</related-article>
<abstract abstract-type="web-summary" specific-use="electronic-only">
<p>The clinical and EEG features and reasons for frequent misdiagnosis of juvenile myoclonic epilepsy are reviewed by the Epilepsy Research Group, Institute of Neurology, National Hospital, and St Thomas&#x2019; Hospital, London, England.</p>
</abstract>
<kwd-group>
<kwd>Frequent Misdiagnosis</kwd>
<kwd>Absence Seizures</kwd>
<kwd>Myoclonic Jerks</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<p>The clinical and EEG features and reasons for frequent misdiagnosis of juvenile myoclonic epilepsy are reviewed by the Epilepsy Research Group, Institute of Neurology, National Hospital, and St Thomas&#x2019; Hospital, London, England. The triad of absence seizures, myoclonic jerks, and GTCSs shows a characteristic age-related onset. Absence seizures begin between 5 and 16 years, myoclonic jerks follow about 4 years later, usually around age 15 years, and GTCSs appear within a few months after the myoclonic jerks. Myoclonic jerks and GTCSs occur mainly on awakening. Apart from tremor, the neurologic exam is normal. Photosensitivity is present in 50% of patients, and seizures are precipitated by sleep deprivation, fatigue, alcohol, anxiety, and hyperventilation. Treatment with valproic acid is usually effective, and may be supplemented with clonazepam at bedtime if necessary. Lifelong anticonvulsant treatment is required, and withdrawal of medication may result in status epilepticus. [<xref ref-type="bibr" rid="CIT0001">1</xref>]</p>
<disp-quote>
<p><bold>COMMENT</bold>. A high index of suspicion for JME is indicated in young patients with early-morning seizures, especially those poorly controlled with carbamazepine or associated with sleep deprivation or alcohol consumption.</p>
<p>Diagnosis of JME was delayed by a mean of 14 years in 15 patients identified among 180 referrals to a new epilepsy clinic at St Thomas&#x2019; Hospital, London, a prevalence of 8.3%. At least 11 had been examined previously by a neurologist, and 7 had received inappropriate anticonvulsants. [<xref ref-type="bibr" rid="CIT0002">2</xref>]</p>
</disp-quote>
</body>
<back>
<ref-list>
<ref id="CIT0001">
<label>1</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Gr&#x00FC;newald</surname>
<given-names>RA</given-names>
</name>
<name>
<surname>Panayiotopoulos</surname>
<given-names>CP</given-names>
</name>
</person-group>
<article-title>Juvenile myoclonic epilepsy. A review</article-title>
<source>Arch Neurol</source>
<year>1993</year>
<month>Jun</month>
<volume>50</volume>
<issue>6</issue>
<fpage>594</fpage>
<lpage>8</lpage>
<pub-id pub-id-type="pmid">8503795</pub-id>
<pub-id pub-id-type="doi">10.1001/archneur.1993.00540060034013</pub-id>
</element-citation>
</ref>
<ref id="CIT0002">
<label>2</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Gr&#x00FC;newald</surname>
<given-names>RA</given-names>
</name>
<name>
<surname>Chroni</surname>
<given-names>E</given-names>
</name>
<name>
<surname>Panayiotopoulos</surname>
<given-names>CP</given-names>
</name>
</person-group>
<article-title>Delayed diagnosis of juvenile myoclonic epilepsy</article-title>
<source>J Neurol Neurosurg Psychiatry</source>
<year>1992</year>
<month>Jun</month>
<volume>55</volume>
<issue>6</issue>
<fpage>497</fpage>
<lpage>9</lpage>
<pub-id pub-id-type="pmid">1619419</pub-id>
<pub-id pub-id-type="doi">10.1136/jnnp.55.6.497</pub-id>
</element-citation>
</ref>
</ref-list>
</back>
</article>
