Juvenile Myoclonic Epilepsy: Treatment, Prognosis, Causes, Symptoms
Juvenile myoclonic epilepsy (JME) is a type of epilepsy, which begins in childhood or adolescence. Juvenile myoclonic epilepsy is a common type of epilepsy. Individuals with this disorder have jerking or twitching of the muscles. There also are seizure types with JME, such as absence seizures or full-blown convulsive seizures.
Treatment for Juvenile myoclonic epilepsy comprises of an epilepsy medicine, which works for multiple types of seizures and making healthy lifestyle changes.
Signs & Symptoms of Juvenile Myoclonic Epilepsy
A person usually develops Juvenile Myoclonic Epilepsy in late childhood, around puberty or in adolescence. There are three different types of seizure, which can occur in juvenile myoclonic epilepsy and they are:
- One of the defining symptoms of juvenile myoclonic epilepsy is myoclonic seizures. Myoclonic seizures consist of small quick and sudden jerks of the arms, shoulder or legs. Patient commonly experiences myoclonic seizures in the early morning, immediately after waking up.
- Convulsive seizures or generalized tonic-clonic seizure occur if the myoclonic seizures spread to the rest of the brain.
- Absence seizures also affect the entire brain where a person does not respond and stares blankly into space for some period of time. Absence seizures do not cause any convulsing or twitching. These seizures often go unnoticed or are thought of as inattentiveness or daydreaming.
Causes & Risk Factors of Juvenile Myoclonic Epilepsy
The exact cause of Juvenile Myoclonic Epilepsy is not known as is the case with other types of epilepsy. Some of the risk factors which increase the likelihood of developing JME include:
- Children suffering from childhood absence epilepsy are more at a risk for developing juvenile myoclonic epilepsy.
- Having a family history of epilepsy increases the risk of developing juvenile myoclonic epilepsy.
- Genetic factor also plays an important role in juvenile myoclonic epilepsy. There are multiple genes which are identified to increase the risk of having JME.
- In some cases, juvenile myoclonic epilepsy can also be triggered by flickering lights, such as strobe lighting at a party or the sun reflecting off of the ocean waves. Some individuals will develop seizures through some actions, such as acts of concentration such as calculations or decision making.
- People who drink alcohol heavily or are sleep deprived are at an increased risk for having Juvenile myoclonic epilepsy or JME seizures.
Investigations of Juvenile Myoclonic Epilepsy
Diagnosis of juvenile myoclonic epilepsy is done on the basis of myoclonic jerks along with other type of seizures. There are some tests which help in confirming the diagnosis of juvenile myoclonic epilepsy:
- EEG (Electroencephalogram): This is a painless test, which is done by attaching adhesive electrodes to the scalp. Brain waves are then recorded and interpreted by a neurologist. There is a pattern of waves and spikes commonly present in juvenile myoclonic epilepsy, particularly if Juvenile myoclonic epilepsy or JME is triggered by flashing lights. For confirmation of diagnosis, an EEG may be done while sleeping and immediately after wakening.
- CT scan or Computed Tomography Scan: This is a brain scan, which generates lower quality images than MRI; however, it is faster and easily accessible. Patient will have a normal CT brain scan if he/she is having juvenile myoclonic epilepsy.
- The important thing for diagnosing juvenile myoclonic epilepsy is the additional presence of convulsive seizures or absence seizures, as myoclonic jerks of the arms and legs are also common in individuals who do not have epilepsy. They occur normally when a person falls to sleep.
Treatment of Juvenile Myoclonic Epilepsy
Valproate or valproic acid (Depakote ) is a broad-spectrum anti-seizure drug commonly used to treat juvenile myoclonic epilepsy and is helpful in treating all the three seizure types, which occur with Juvenile myoclonic epilepsy or JME. There are other epilepsy drugs, which also are effective in treating juvenile myoclonic epilepsy. Treatment is most effective when it helps in controlling all the three seizure types, which are seen in juvenile myoclonic epilepsy. Some of the medicines which help in controlling and treating juvenile myoclonic epilepsy include levetiracetam (Keppra), topiramate (Topamax), and lamotrigine (Lamictal).
Making lifestyle changes is also important, such as getting enough sleep for about 8 to 10 hours, going to bed early, avoiding alcohol, caffeine, tea and cola drinks; all these things are important in treating Juvenile myoclonic epilepsy or JME.
Majority of the patients suffering from Juvenile myoclonic epilepsy or JME have to undergo long-term and usually lifelong treatment. Effective treatment helps in allowing many patients suffering from juvenile myoclonic epilepsy to go without seizures for five years or so.
Prognosis of Juvenile Myoclonic Epilepsy
The prognosis of Juvenile myoclonic epilepsy or JME is mostly good as excellent control of seizures can be achieved in patients suffering from JME with comparatively low doses of anticonvulsants, such as valproic acid. The risk of relapse of Juvenile myoclonic epilepsy, however, is great if the anticonvulsants are stopped. For this reason, treatment is often required for lifelong.