Juvenile myoclonic epilepsy (JME) in children
Juvenile myoclonic
epilepsy (JME) is a type of epilepsy that begins in childhood or adolescence.
People suffering from
it wake up with sharp and rapid movements of the arms and legs. This is called
myoclonic twitches.
Even if you don't
have epilepsy, you've probably had those tremors that wake you up, often when
you're about to fall asleep. But people with JME usually have other types of
seizures.
After the age of 30,
seizures tend to decrease. And drugs can keep JME under control. But most
patients will have to take the drug for the rest of their lives, even if they
stop having seizures.
Symptoms
The first seizures
usually begin between the ages of 5 and 16. People with JME have three
different types:
- Absence seizures are usually the first type of JME in children. During these episodes, he may appear to be daydreaming or wandering for approximately 10 seconds. Therefore, you may not even notice when they happen.
- Myoclonic seizures—convulsive movements in one or both arms and legs—usually begin after 1–9 years, around age 14–15. Some children will only have erratic finger movements. Because of this, they can drop things and look awkward.
- Tonic-clonic seizures usually start after a few months. During these seizures, the muscles of the whole body of the child become stiff and twitch rhythmically. He will lose consciousness and may fall to the ground. They usually last from 1 to 3 minutes.
Attacks often occur
within 30 minutes to an hour after waking up in the morning or after sleep. A
group of myoclonic jerks may be a warning sign of an impending tonic-clonic
seizure.
About 1 in 6 people
with JME have only myoclonic jerks and no other types of seizures.
What causes JME?
Doctors don't know
exactly why some people develop JME. But it may be due to genes that are passed
down in your family. About a third of people with this disorder have relatives
with seizures.
However, it is clear
that certain things tend to cause seizures. The most common triggers are lack
of sleep and too much stress.
Alcohol consumption,
which can lead to sleep deprivation and fatigue, is the strongest trigger for
myoclonic seizures and tonic-clonic seizures.
In some people,
flickering lights can also trigger seizures. This can happen while watching TV,
playing video games, or outdoors with light flickering through trees, waves, or
snow.
Some girls and women
also have cramps during their periods.
Getting a diagnosis
Doctors diagnose JME
using an electroencephalogram, a test that detects unusual patterns in brain
waves. You will take the test while you are asleep and awake.
To perform the test,
your medical team places electrodes on your head. They are wired to a computer
that shows the electrical activity of your brain cells. The results look like a
graph of peaks and wavy lines. Your doctor will scan them to look for patterns
that signal JME.
Your doctor may also
want to run imaging tests on your brain, such as magnetic resonance imaging and
CT scans, to see if there is anything else that may be causing your seizures.
Treatment
The first thing a
doctor will recommend for treating JME is lifestyle changes to avoid seizure
triggers. That means getting enough sleep, avoiding alcohol, and finding ways
to deal with stress.
Most people with JME
will also need one or more antiepileptic drugs. They can control seizures in
90% of people with this condition. These drugs include:
- Valproic acid
- Levetiracetam
- Lamotrigine
- Clonazepam
- Topiramate
Valproic acid is the
most effective drug for JME. But women should not take it when they are of
childbearing age. They may try other medications to control seizures.
Most people with JME need lifelong antiepileptic medications, although they may decrease over time.