Abstract
“Idiopathic” generalized epilepsies (juvenile absence epilepsy, juvenile myoclonic
epilepsy, and epilepsy with generalized tonic–clonic seizures alone) are the most
frequent group of epilepsies with onset during adolescence and constitute 15 to 20%
of all epilepsies. These syndromes have overlapping clinical features and genetic
origins as well as similar electroencephalographic findings. There are primarily three
seizure types that occur with these epilepsy syndromes: generalized tonic–clonic,
absence, and myoclonic seizures. Standard neurologic examination and neuroimaging
studies do not generally reveal any abnormality. Potential precipitating factors are
many, including sleep deprivation, fatigue, alcohol use, photic stimulation, and menstruation.
The characteristic electroencephalographic abnormality consists of diffuse, bilateral,
symmetric, and synchronous 4 to 6 Hz polyspike and wave complexes. Idiopathic generalized
epilepsies are generally associated with low mortality and typically respond well
to treatment. The most effective antiepileptic drug for these disorders is sodium
valproate, but it should be used with caution in adolescent females who are of childbearing
age. Levetiracetam, lamotrigine, topiramate, and zonisamide can also be used as effective
monotherapy. Carbamazepine, oxcarbamazepine, phenytoin, gabapentin, and vigabatrin
may exacerbate myoclonic and absence seizures in juvenile myoclonic epilepsy.
Keywords
idiopathic generalized epilepsy - juvenile myoclonic epilepsy - juvenile absence epilepsy
- generalized tonic–clonic seizures
