Juvenile myoclonic epilepsy: Clinical features and factors related to misdiagnosis

We identified 37 patients with juvenile myoclonic epilepsy (JME) out of 740 consecutive epilepsy patients. Only three were initially diagnosed with JME. Factors leading to misdiagnosis included warnings (auras) suggesting partial seizures before tonic-clonic seizures (GTCS), confusion between absence and complex partial seizures, failure of patients to spontaneously report or for physicians to obtain a history of myoclonic jerks, and failure to report myoclonic jerks to medical personnel despite specific questioning. Psychiatric disorders were common: depression occurred in nine and panic disorder in seven patients. Following diagnosis, 86% of patients were seizure-free on antiepileptic drugs. To improve diagnostic sensitivity, patients with epilepsy should be routinely questioned about the occurrence of myoclonic seizures, and JME should not be excluded because patients report nonspecific warnings before GTCS.