Juvenile Myoclonic Epilepsy: What To Expect If Your Child Is Diagnosed?

Juvenile myoclonic epilepsy begins during adolescence and involves sudden myoclonic jerks and muscle contractions

Juvenile myoclonic epilepsy (JME) is a common generalized epilepsy syndrome that typically begins in adolescence or early adulthood, with typical sudden myoclonic jerks in the form of rapid and uncontrolled muscle contractions followed by generalized tonic-clonic seizures a few years later.

It is characterized by myoclonic seizures, which cause rapid and uncontrolled muscle contractions resulting in jerking movements or twitches (sudden jerks).

JME typically begins between the ages of 12 and 18. However some children can have starting symptoms even at the 8-9 years. The seizures in JME can occur at any time, however, they are most common in the morning, shortly after waking up.

Seizure Types In JME

JME can be identified depending upon certain characteristics of seizures: kind of seizures:

• Usually occur within 1-2 hours of waking up in the morning

• Feel like a shock-like movement of both arms. These movements can sometimes be limited to the fingers, giving the impression of clumsy hands prone to dropping things.

• Jerks are random and can happen in any part of the body

• Can have big seizures like grand mal seizures (generalized tonic clonic movements)

• Can have absence seizures (petit mal)

Triggers Of JME

The trigger for the condition is mostly related to the lifestyle of the patient. While several potential triggers for JME seizures have been identified, lack of sleep and stress are the most common causes.

This stress can be mental or emotional, due to excitement or frustration or may be physical due to fatigue or fever.

The other triggers include- alcohol consumption, certain medications, hormonal changes during puberty and menstruation etc. In some cases, seizures are frequently triggered by flashing lights or contrasting light and dark patterns such as strobe lights at dances, TV, and video games, or light shining through trees or reflecting off ocean waves or snow.

Causes And Diagnosis of JME

The exact cause of JME is unknown; however, the condition is known to have some genetic predisposition.

This condition can be diagnosed on the basis of-

• Medical History: To determine the onset, frequency, duration, and characteristics of the seizures

• Electroencephalogram: To record brain waves or measure the electrical activity of the brain

• Blood test: To rule out other conditions that can cause seizures

How Can Parents Help?

Juvenile myoclonic epilepsy in children is a chronic life-long condition. However, many children go on to live normal lives after taking a few precautions to keep them safe.

The parents can take appropriate measures to assist their child in successfully managing their condition. They should make sure that:

• The child follows the neurologist’s recommendations on prescribed medications, avoiding triggers, taking precautions while swimming, bathing etc.

• The child adheres to the medication. With the help of seizure medication, many children/young adults with JME can achieve total or nearly total seizure control. It allows most patients to live a normal life. Patients with multiple seizure types may require a variety of seizure medications to control their seizures.

• The other adults and caregivers (such as family members, babysitters, teachers, coaches, etc.) are informed and trained to manage the seizures and keep the child safe in case of absence of their parents.

• Parents/ caregivers should seek immediate medical care in case of seizure lasting for more than 5 minutes, repetitive seizures with no return of consciousness in between, trouble breathing, injury due to falls and hits, or lips, tongue and face turning bluish.

Parents and caregivers can also follow following steps to control seizures in children in case of emergency by:

• Gently placing the child on the floor or ground while removing the nearby objects

• Laying the child turned to one side to prevent choking

• Loosening the child's clothing around the neck

• Making sure the child is breathing fine

• Avoiding putting anything in the child's mouth

• Waiting for seizures to stop before giving any medicine in the form of pills or liquid

• Keeping track of how long the seizure lasted

• Making a video of the event if feasible

• Let the child rest after a seizure

In addition to the above, JME can be managed through lifestyle changes.

Parents should ensure that their child maintains regular sleep schedule, manages stress, and avoids indulging in consumption of alcohol and drugs. It is important for parents to work closely with a healthcare provider to develop an individualized treatment plan for their child.

(Dr Atma Ram Bansal is the Associate Director of Epilepsy Programme, Institute of Neurosciences, Medanta, Gurugram.)