An adolescent school girl complaints of dropping objects from hands, it gets precipitated during morning and during exams. There is no history of loss of consciousness and her cousin sister has been diagnosed with epilepsy. EEG was done and was suggestive of epileptic spikes. What is the diagnosis?
(A) Juvenile myoclonic epilepsy (B) Atypical absence (C) Choreo - athetoid epilepsy (D) Centrotemporal spikes
(A) - History given suggests the diagnosis of Juvunile myoclonic epilepsy Juvunile myoclonic epilepsy ( Janz Syndrome ) - Most common generalized epilepsy in young adults. - Stas in early adolescence with 1 or more of: Myoclonic jerks in morning, causing patient to drop things Generalized tonic-clonic seizures upon awakening Juvenile absences. - Sleep deprivation and photic stimulation can act as precipitants. - EEG shows generalized 4-5 Hz polyspike and slow wave discharge. OTHER OPTIONS: Atypical absence seizures - Less abrupt onset and offset of loss of awareness - Associated myoclonic components and tone changes of head and body - Precipitated by drowsiness - Accompanied by 1 to 2 hz spike and slow wave discharge. Benign childhood epilepsy syndrome with centrotemporal spikes - Rolandic epilepsy - Stas during childhood and is outgrown in adolescence. - Child wakes up at night owing to focal seizures causing buccal and throat tingling and tonic clonic contractions of 1 side of face, with drooling and inability to speak but with preserved consciousness and comprehension. - EEG shows typical broad based centrotemporal spikes that are markedly increased in frequency during drowsiness and sleep. - MRI is normal. - Patient respond well to carbamazepine.