Juvenile myoclonic epilepsy — RACP Paediatrics MCQ

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ModerateNeurologyJuvenile myoclonic epilepsyRACP Paediatrics

A 15-year-old boy presents with early morning myoclonic jerks and a generalised tonic-clonic seizure. EEG shows generalised polyspike-and-wave discharges. He is diagnosed with juvenile myoclonic epilepsy. What is the most appropriate first-line antiepileptic drug?

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Correct answer: D — Sodium valproate

Sodium valproate is the most effective first-line treatment for juvenile myoclonic epilepsy (JME). JME is a lifelong condition requiring ongoing treatment. Carbamazepine and phenytoin should be avoided as they may worsen myoclonic and absence seizures. In females of childbearing age, levetiracetam or lamotrigine is preferred due to valproate teratogenicity.

Reference: Australian Therapeutic Guidelines – 2024 – Neurology; RACP Paediatric Curriculum – Neurology