2006 Volume 24 Issue 4 Pages 268-273
A 21 year old woman had had myoclonic seizures since the age of nine. She was diagnosed as juvenile myoclonic epilepsy. Her myoclonic seizures were completely suppressed with valproate, however, she had frequent generalized tonic-clonic seizures. At the age of 23, she developed other seizures, consisting of brief contraction of the four limbs. Therefore, she was admitted and video-EEG monitoring was performed. The seizues were very similar to tonic seizure. Her generalized tonic-clonic seizure and tonic like seizure were successfully treated with phenytoin. Tonic seizures are commonly associated with epilepsy that has widespread cerebral dysfunction, such as symptomatic generalized epilepsy. But this patient exhibited features consistent with idiopathic generalized epilepsy (clinically, electroencephalographically), and didn't show neurological impairment and abnormal radiological findings. Therefore, she was diagnosed as juvenile myoclonic epilepsy with tonic like seizures. It is suggested that tonic like seizures may occur in these patients with juvenile myoclonic epilepsy. We have to take care to diagnose and treat of such patients.
