John Libbey Eurotext

Focal epilepsy recruiting a generalised network of juvenile myoclonic epilepsy: a case report Volume 16, numéro 3, September 2014


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1 Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
2 Department of Medicine, University of Medicine, Mandalay, Myanmar
* Correspondence: Kheng-Seang Lim Neurology Laboratory, 6th Floor, Menara Selatan, University Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia

We report a patient with juvenile myoclonic epilepsy who subsequently developed temporal lobe epilepsy, which gradually became clinically dominant. Video telemetry revealed both myoclonic seizures and temporal lobe seizures. The temporal lobe seizures were accompanied by a focal recruiting rhythm with rapid generalisation on EEG, in which the ictal EEG pattern during the secondary generalised phase was morphologically similar to the ictal pattern during myoclonic seizures. The secondary generalised seizures of the focal epilepsy responded to sodium valproate, similar to the myoclonic epilepsy. In this rare case of coexistent Juvenile Myoclonic Epilepsy and Temporal lobe epilepsy, the possibility of focal epilepsy recruiting a generalised epileptic network was proposed and discussed.