Juvenile myoclonic epilepsy — SCE Neurology MCQ

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HardEpilepsyJuvenile myoclonic epilepsySCE Neurology

A 19-year-old has early-morning generalised tonic-clonic seizures and brief bilateral arm jerks after sleep deprivation. MRI is normal and EEG shows generalised 4–6-Hz polyspike-and-wave activity. What is the diagnosis?

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Correct answer: C — Juvenile myoclonic epilepsy

The best answer is “Juvenile myoclonic epilepsy”. Morning myoclonus, generalised convulsions, sleep-deprivation sensitivity and generalised polyspike-wave in an otherwise neurologically normal adolescent are classic for juvenile myoclonic epilepsy. “Childhood absence epilepsy” is less appropriate because childhood absence epilepsy presents earlier with frequent 3-Hz absence seizures “Focal temporal epilepsy” is less appropriate because focal epilepsy does not fit the bilateral myoclonus and generalised EEG “Progressive myoclonic epilepsy” is less appropriate because progressive myoclonic epilepsy includes neurological deterioration and additional features “Functional seizures” is less appropriate because the electroclinical generalised discharge is positive evidence for epilepsy

Reference: NICE NG217: Epilepsies in children, young people and adults. https://www.nice.org.uk/guidance/ng217/chapter/Recommendations