Hamid Reza Riasi, Fariba Nakhaei, Kavian Ghandehari, Frood Salehi, Zahra Toraby, Mojtaba Teimoori.
Clinical evaluation of 32 patients with juvenile myoclonic epilepsy in Southern Khorasan.
Pak J Neurological Sci Jan ;4(1):4-7.

Juvenile Myoclonic Epilepsy (JME) is a frequent type of generalized seizure often associated with generalized tonic-clonic seizure (GTCS) and absence attacks. Methods: Consecutive patients with probable diagnosis of seizure referred to Valie-Asr and Emam Reza hospitals in southern Khorasan during March 2005-May 2007 were evaluated. Diagnosis of epilepsy and JME was made by neurologists based on clinical manifestations, history and EEG findings. Patients with structural brain lesions were excluded. Results: Of a total 396 epileptic patients, 32 JME cases (8.1%; 18 males, 14 females) were investigated. Mean age of JME onset and age at diagnosis were 12.4 years and 14.2 years, respectively; 27 patients with JME had GTCS and 7 patients had absence-type epilepsy. The triad of myoclonus, GTCS and absence spells was seen in only 4 cases while 2 cases had pure myoclonus. Myoclonic jerks were predominantly unilateral (or at least unilateral at onset) in 8 patients (25%). In 28 cases (87.5%), attacks predominantly occurred on awakening. Sleep deprivation was the most important precipitating factor, found in 26 cases (81.3%). Characteristic epileptic pattern of JME was found in 71.9% in the first EEG, which increased to 94% with repeat EEG. Positive family history for epilepsy was seen in 25%. Conclusion: JME is a frequent subtype of generalized epilepsy often associated with GTCS and absence. JME patients usually have a characteristic epileptic pattern on EEG.

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