Clinical and neuropsychological considerations in a case of unrecognized myoclonic epileptic jerks dramatically controlled by levetiracetam

Neuropediatrics. 2010 Dec;41(6):270-2. doi: 10.1055/s-0031-1273704. Epub 2011 Mar 28.

Abstract

The International League Against Epilepsy (ILAE) classification recognizes 2 forms of myoclonic epilepsy with a good prognosis: benign myoclonic epilepsy of infancy (BMEI) and juvenile myoclonic epilepsy (JME); recent studies confirm the efficacy of levetiracetam (LEV) in treating idiopathic generalized epilepsies (IGE) in patients with myoclonic seizures. We report a girl referred to our Child Neuropsychiatry Unit at age 9 years because of massive myoclonic jerks, previously diagnosed as tics. Neuropsychological examination evidenced mild cognitive impairment. The clinical and electroencephalogram (EEG) data led to diagnosis of BMEI with late presentation. A dramatic suppression of interictal and ictal epileptiform activity was achieved after only one intake of LEV. Another neuropsychological examination after 6 months of treatment showed performance improvement probably related to EEG modifications. LEV may be suitable for the first-line treatment of myoclonic idiopathic seizures.

Publication types

  • Case Reports

MeSH terms

  • Anticonvulsants / therapeutic use*
  • Child
  • Cognition Disorders / complications
  • Electroencephalography
  • Epilepsies, Myoclonic / complications
  • Epilepsies, Myoclonic / diagnosis
  • Epilepsies, Myoclonic / drug therapy*
  • Female
  • Humans
  • Levetiracetam
  • Myoclonus / complications
  • Myoclonus / diagnosis
  • Myoclonus / drug therapy*
  • Neuropsychological Tests
  • Piracetam / analogs & derivatives*
  • Piracetam / therapeutic use
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Levetiracetam
  • Piracetam