Juvenile Myoclonic Epilepsy

What is Juvenile Myoclonic Epilepsy?

Juvenile Myoclonic Epilepsy is otherwise known as Janz syndrome, Myoclonic epilepsy or impulsive petit mal which was described first by Dr. Dieter Janz during the year 1956. Most of the persons inflicted with Juvenile Myoclonic Epilepsy are those at the age between 8 to 26 years old. In addition to that, most of those who are inflicted with this disease are girls than boys. It is a familial kind of disease that has a characteristic of generalized kind of clonic tonic or tonic clonic seizure, milder form of Myoclonic seizure, and absence seizure. It is the common epileptic syndrome.

Generally speaking, the juvenile Myoclonic epilepsy may exist during puberty stage but may have the possibility when it exists prior to puberty stage. It can be precipitated by awakening early, usage of drug and consumption of alcoholic beverages, stress, deprivation of sleep, stimulation of photic, menstruation and emotions that are strong.

Juvenile Myoclonic Epilepsy Symptoms

Fig 1 – A child Exhibiting A Myoclonic Seizure

Persons with juvenile Myoclonic epilepsy reports to manifest the following symptoms such as:

• Myoclonic seizure which occurs in the early morning

Myoclonic seizure may have the tendency spread through the person’s brain. It can lead to quick, sudden, small jerk of the legs, arms or shoulders.

• Tonic clonic seizure or convulsive seizure

It is otherwise known as gran mal seizure or grand mal seizure. It is known to be a generalized kind of seizure which affects the entirety of the brain.

• Absence seizure

This kind of seizure happens in any day but most often occurs in the morning. It is otherwise known as petit mal seizure. It occurs in a brief for approximately 20 seconds maximum length. The person who has absence seizure generally has an impaired consciousness and a spike and slow wave discharges in their EEG.

• Photosensitive seizures

This kind of seizure is provoked by flickering lights like television, light shining via the trees, strobe lights and the like.

Juvenile Myoclonic Epilepsy Causes

Juvenile Myoclonic Epilepsy has an idiopathic cause or etiology or in layman’s term the cause is still unknown. It is considered to be genetic in nature. According to research, fifty percent of those who were diagnosed or who suffer from Juvenile Myoclonic Epilepsy have a family medical history of epilepsy or seizure. Some persons usually have absence seizure or febrile seizure prior to the development of Juvenile Myoclonic Epilepsy.

Juvenile Myoclonic Epilepsy Diagnosis

The diagnosis of Juvenile Myoclonic Epilepsy will be dependent on the presence of the Myoclonic jerks plus other additional seizure kinds as well as the patient’s physical examination and medical historical data. The various examinations can also aid in the diagnosis that will confirm that the person truly has Juvenile Myoclonic Epilepsy:

• MRI or Magnetic Resonance Imaging

This is a kind of test that uses a high resolution scan of the brain wave.

• CT scan or Computed Tomography Scanning

This is another brain scan that makes a low quality of images compared to that of the magnetic resonance imaging. The main advantage of this compared to magnetic resonance imaging is that it is available and it produces a faster imaging results.

• EEG or Electroencephalogram

With this test, there will be a serious of adhesive type of electrodes which will be attached to the person’s scalp. After attaching, the technician will then record the waves in the brain. This test is painless and noninvasive kind. After the recording of the brain waves, the neurologist will then interpret the results of the EEG. For persons who are suspected to have Juvenile Myoclonic Epilepsy, they are suggested to do the EEG while the person is fast asleep and then when they just wake up from their sleep.

An EEG of a 12 year old patient with Juvenile Myoclonic Epilepsy Showing Myoclonic Jerks in the Middle

Most of the diagnostic tests, as observed, are brain scans or brain wave recording because as mentioned in the symptoms section, the Juvenile Myoclonic Epilepsy is a kind of epilepsy that targets the brain. Hence, there is a need to monitor the brain activity of the person with Juvenile Myoclonic Epilepsy. From the diagnostic tests that were mentioned, the EEG provides the confirmative diagnostic test for Juvenile Myoclonic Epilepsy.

Juvenile Myoclonic Epilepsy Treatment

According to studies conducted, the person with Juvenile Myoclonic Epilepsy has a great response mostly to the treatment given, if for in any instance, the diagnosis was made correctly. The following are the treatment been suggested and works effectively with persons having Juvenile Myoclonic Epilepsy:

Lifestyle changes

This is the most important thing that one needs to be informed when a person has Juvenile Myoclonic Epilepsy. He or she needs to change or modify his or her lifestyle. He or she needs to be informed about precautions needed during seizure activity such as:

• Avoiding sleep deprivation
• Avoiding the excess of alcoholic consumption
• Restrictions in driving
• Occupational hazards

Medical treatment

The medications that are commonly prescribed to persons with Juvenile Myoclonic Epilepsy are medications that belong to the category under anticonvulsant medications. The first choice of drug in the treatment for Juvenile Myoclonic epilepsy is the medication named sodium valproate. Yet such medication should be avoided in childbearing age women for it can lead to high risk of delay in the neurodevelopmental growth as well as malformation of the fetus.

Surgical treatment

This is often not indicated to persons with Juvenile Myoclonic Epilepsy for it is considered to be under the category of generalized kind of epilepsy. Although, studies have shown that vagal nerve stimulation may be beneficial for persons with Juvenile Myoclonic Epilepsy.

Juvenile Myoclonic Epilepsy Prognosis

Even if the Juvenile Myoclonic Epilepsy is considered to be a benign condition, still it should not be put aside. Failure in diagnosing this condition will affect the morbidity of the person. In addition to that, all persons with Juvenile Myoclonic Epilepsy are in their treatment for the rest of their lives. Persons with Juvenile Myoclonic Epilepsy are at high risk for relapse if the treatments are discontinued. In sum, according to research, the long term prognosis is good provided that the necessary treatments are given.