JME is a common cause of juvenile/adolescent seizures.
Patients typically present between 12-18 years of age with a combination of myoclonic movements, absence seizures and generalized tonic-clonic seizures.
This diagnosis is often mistaken for morning clumsiness due to the myoclonic movements and asking about myoclonic movements can help make the diagnosis.
Diagnosis:
Diagnosis is primarily based on history. Myoclonic seizures are required to make the diagnosis. Patients with consistent history can receive outpatient EEG to confirm the diagnosis. No ED images or tests needed with the correct clinical history and return to baseline. (even outpatient with appropriate history imaging is not needed as it is usually normal)
Treatment:
Valproic acid is typically the treatment of choice for patients though must be used with caution in women of childbearing age. Other common treatment options include levetiracetam and lamotrigine. With the correct clinical history, these can be started in the ED.
Be sure to discuss good sleep hygiene and avoidance of alcohol with patients as these can be triggers.
References
Mantoan L, Walker M. Treatment options in juvenile myoclonic epilepsy. Curr Treat Options Neurol. 2011 Aug;13(4):355-70. doi: 10.1007/s11940-011-0131-z. PMID: 21494841.
