Murthy Jagarlapudi M K
CARE Institute of Neurosciences, CARE Hospitals, Banjara Hills, India.
J Epilepsy Res. 2020 Dec 31;10(2):92-95. doi: 10.14581/jer.20015. eCollection 2020 Dec.
Status epilepticus (SE) is rare in juvenile myoclonic epilepsy (JME). This report presents three patients with myoclonic status epilepticus (MSE). MSE is defined as prolonged period of myoclonic jerks that are correlated with epileptiform discharges on electroencephalogram. The precipitating factors among the three patients were: introduction of carbamazepine in case1, missing the dose in case2, and introduction of oxcarbazepine in case3. Of the three patients, one patient was a misdiagnosed case of JME. In him the diagnosis of JME was established after 35 years when he developed MSE with the addition of oxcarbazepine to the antiseizure medication (ASM) which he was taking. Detailed review of the history revealed that he used to get occasional myoclonic jerks with deprived sleep and stress. This patient illustrates that the diagnosis of JME can be missed or delayed if history of myoclonic jerks is not elicited, particularly in patents with pubertal onset epilepsy. The other lesson is that possibility of JME should be considered in patients with drug resistant epilepsy (pseudo-drug resistance).
癫痫持续状态（SE）在青少年肌阵挛癫痫（JME）中较为罕见。本报告介绍了3例肌阵挛癫痫持续状态（MSE）患者。MSE被定义为与脑电图上的癫痫样放电相关的长时间肌阵挛抽搐。这3例患者的诱发因素分别为：病例1中引入卡马西平，病例2中漏服药物剂量，病例3中引入奥卡西平。3例患者中，有1例曾被误诊为JME。在他服用抗癫痫药物（ASM）期间加用奥卡西平后发生MSE，35年后才确诊为JME。详细回顾病史发现，他过去在睡眠不足和压力大时偶尔会出现肌阵挛抽搐。该患者表明，如果未询问到肌阵挛抽搐病史，尤其是青春期起病的癫痫患者，JME的诊断可能会被漏诊或延迟。另一个教训是，对于药物难治性癫痫患者（假性药物难治性），应考虑JME的可能性。
