Juvenile myoclonic epilepsy

Abstract

-Juvenile myoclonus epilepsy (JME) is a common epileptic syndrome, the etiology of which is genetically determined. Its onset occurs from 6 through 22 years of age, and affected patients present with myoclonic jerks, often associated with generalized tonic-clonic seizures -the most common association -and absence seizures. JME is non-progressive, and there are no abnormalities on clinical examination or intellectual deficits. Psychiatric disorders may coexist. Generalized polyspike-and-waves are the most characteristic electroencephalographic pattern. Usual neuroimaging studies show no abnormalities. Atypical presentations should be entertained, as they are likely to induce misdiagnosis. Prevention of precipitating factors and therapy with valproic acid (VPA) are able to control seizures in the great majority of patients. Whenever VPA is judged to be inappropriate, other antiepileptic drugs such as lamotrigine may be considered. Treatment should not be withdrawn, otherwise recurrences are frequent.KEY WORDS: juvenile myoclonic epilepsy, diagnosis, etiology, treatment. Epilepsia mioclônica juvenilRESUMO -A epilepsia mioclônica juvenil é uma síndrome epiléptica comum, cuja etiologia é fundamentada na genética. Inicia-se entre 6 e 22 anos e os indivíduos apresentam mioclonias, que podem ser acompanhadas por crises tônico-clônicas generalizadas -associação mais comum -e crises de ausência. A doença não é progressiva, e não há alterações detectáveis no exame físico ou déficits intelectuais. Distúrbios psiquiátri-cos podem coexistir. Polipontas-ondas lentas generalizadas constituem o padrão eletrencefalográfico ictal típico. Não há anormalidades em exames de imagem convencionais. Apresentações atípicas devem ser consideradas, pois predispõem a erros de diagnóstico. A prevenção de fatores desencadeantes e o uso de áci-do valpróico (VPA) controlam as crises epilépticas na grande maioria dos casos. Quando o VPA é inapropriado, outras drogas como a lamotrigina podem ser utilizadas. O tratamento não deve ser interrompido, visto que as recidivas são freqüentes.

Upper cervical chiropractic care for a 25-year-old woman with myoclonic seizures

“…Symptoms include myoclonic jerks, often associated with generalized tonic-clonic seizures and absence seizures. 2 There are typically no abnormalities seen on clinical examination or any intellectual deficits associated with JME. It is nonprogressive.…”

“…It is nonprogressive. 2 The etiology of JME is thought to stem from genetics. 2,3,7 Patients report that certain factors such as sleep deprivation, menses, alcohol, and overall stress can increase their incidence of seizure.…”

“…2,3,7 Patients report that certain factors such as sleep deprivation, menses, alcohol, and overall stress can increase their incidence of seizure. 2,3,8 The most characteristic electroencephalographic pattern is generalized multiple high-frequency spikes followed by slower waves. 2,8 Neuroimaging studies generally show no abnormalities.…”

“…The prevalence of epilepsy in those younger than 18 years is estimated to be 4.7 per 1000. 1,2 Juvenile myoclonic epilepsy (JME) accounts for about 10% of all epileptic patients. It is the most common idiopathic generalized epileptic syndrome, having a prevalence of 10 to 20 per 100 000.…”

“…It is the most common idiopathic generalized epileptic syndrome, having a prevalence of 10 to 20 per 100 000. 2,3 Very few case reports have been published on chiropractic management of JME. The purpose of this article is to describe the chiropractic management of a patient with an 11-year history of JME.…”