JUVENILE MYOCLONIC EPILEPSY - AN UNDERDIAGNOSED SYNDROME

Since the first description of juvenile myoclonic epilepsy (JME) in th e English literature in 1984, the delay in correct diagnosis of JME re mains unchanged. Ninety patients with JME were studied. Median delay i n diagnosis was 9 years (range 0-52 years). Reasons for delay in diagn osis were analyzed. Failure to recognize the myoclonic seizures (MS) w as the most common element contributing to the delay. In some eases, M S were not reported by the patients; in other cases, MS were confused with nervousness or clumsiness and not interpreted as epileptic in nat ure by the referring physicians. Clinical and EEG asymmetries were the second most important cause for misdiagnosis. In 53.7% of these cases , asymmetries were interpreted as partial features. The third cause of misdiagnosis was the lack of recognition of the MS associated with no rmal interictal EEGs. These cases were interpreted as nonepileptic sei zures. It is important to be aware of this frequent epileptic syndrome , in which nearly 90% of cases can be controlled with adequate treatme nt (valproate, VPA).