Epilepsy with myoclonic absences

Abstract

We describe our experience with a 14-year-old boy whowasdiagnosed to have epilepsywithmyoclonic absences (EMA). This boy presented with seizures since 7 yr of age. Seizures were in the form of sudden onset myoclonic jerks involving muscles of shoulders and arms, concomitant tonic contraction lead to a progressive elevation of the upper extremities. These episodes were associated with loss of awareness. Each episode lasted for around 20–30 sec. There was no prodrome, aura, post-ictal drowsiness, or confusion. He used to have 15–20 episodes per day. There was no history of photosensitivity. Seizures were more frequent on awakening. He was born of non-consanguineous marriage. Perinatal history was uneventful. He was developmentally normal. No other family member had seizure. He had never received any treatment. Scholastic performance was average. Examination revealed no abnormalities. Hyperventilation lead to precipitation of seizure, in which jerks associated with abduction and elevation of bilateral upper limbs, and vacant stare lasting 30 sec were noted. Magnetic resonance imaging of the brain was normal. Interictal electroencephalography showed normal background. Ictal electroencephalography showed 3Hz spike wave discharges, with abrupt onset and termination (Fig. 1). On the basis of clinical and electroencephalographyfindings, he was diagnosed to have