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August 2004

Evolving Antiepileptic Drug Treatment in Juvenile Myoclonic Epilepsy

Arch Neurol. 2004;61(8):1328. doi:10.1001/archneur.61.8.1328-a

The article by Prasad et al1 is a timely endeavor to readdress antiepileptic drug (AED) treatment in juvenile myoclonic epilepsy (JME) with the current pharmacopoeia. Numerous studies have established that approximately 80% of patients with JME become seizure-free when treated with valproate.1-6 Clonazepam, even in small doses, has a potent antimyoclonic effect. Phenytoin is often ineffective or worsens seizures. Carbamazepine is contraindicated because it aggravates JME in 68% of patients; however, occasionally it may improve the control of generalized tonic-clonic seizures. Historically, phenobarbitone and primidone were the preferred drugs and are still used in Europe and developing countries.5,6