Seizures: Is My 16-Year-Old Experiencing Epilepsy?

Epilepsy Concerns

Hello doctor, my son, who is 16 years old, suddenly experienced upper body tremors last week.
He can have over 60 episodes in a day, and during severe instances, he is unable to hold onto objects, leading to drops and even a fall once.
However, each episode lasts only a short time, and he remains fully aware during the tremors.
He has shown some improvement in the past few days, but he still experiences tremors three to four times daily.
Could this be a form of epilepsy? We do not have a family history of this condition.
Thank you.

Max, 40~49 year old female. Ask Date: 2023/03/13

Dr. Jiang Junyi reply Neurology

Dear Mr.
Max,
Regarding your son, it may be advisable to consider juvenile myoclonic epilepsy.
This condition manifests with myoclonic jerks and generalized tonic-clonic seizures in otherwise normally developing adolescents or adults.
Myoclonic jerks often occur in the hands, shoulders, and legs, particularly shortly after waking (within 30 minutes to an hour after awakening), but can also occur during sleep or randomly.
These jerks can be unilateral or bilateral, may happen once or several times, and sometimes lead to sudden falls.
Since your son is under 18 years of age, I recommend accompanying him to a pediatric neurologist for further discussion.
Thank you for your inquiry, and if you have any related questions, feel free to discuss them further!
Wishing you good health and peace,
Dr.
Jiang Junyi, Taoyuan Hospital

Reply Date: 2023/03/13

More Info

Understanding seizures and their potential implications can be quite challenging, especially when it involves a young individual like your 16-year-old son. Based on your description of his symptoms—frequent upper body shaking, loss of grip strength, and the fact that he remains aware during these episodes—there are several considerations to explore.

Firstly, the symptoms you describe could potentially align with a condition known as myoclonic jerks or myoclonic seizures. These types of seizures are characterized by sudden, brief involuntary muscle jerks. They can occur in isolation or as part of a broader seizure disorder, such as juvenile myoclonic epilepsy (JME), which typically manifests in adolescents. In JME, individuals often experience myoclonic jerks, generalized tonic-clonic seizures, and sometimes absence seizures. Importantly, during myoclonic jerks, the person is usually aware and conscious, which fits your son's experience.

The frequency of his episodes—up to 60 times a day—along with the fact that he occasionally drops objects or falls, raises the possibility that these could be seizure-related. However, it is also essential to consider other factors that might contribute to such symptoms, including stress, fatigue, or even certain medical conditions that may not be directly related to epilepsy.

Given that your son has no family history of epilepsy, it does not rule out the possibility of developing a seizure disorder. Epilepsy can occur sporadically, and many individuals with epilepsy do not have a family history of the condition. Therefore, it is crucial to seek a thorough evaluation from a pediatric neurologist who specializes in seizure disorders. They may recommend an electroencephalogram (EEG) to monitor brain activity and identify any abnormal electrical discharges that could indicate epilepsy.

In addition to the EEG, a comprehensive medical history and physical examination will be essential in determining the underlying cause of your son's symptoms. The neurologist may also inquire about any potential triggers, such as sleep deprivation, stress, or dietary factors, that could exacerbate his condition.

Treatment options for epilepsy vary widely and may include antiepileptic medications, lifestyle modifications, and in some cases, dietary therapies. The choice of medication will depend on the specific type of seizure disorder diagnosed and your son's overall health profile. It is also important to monitor the effectiveness of any prescribed treatment and adjust as necessary, as some individuals may respond better to certain medications than others.

In conclusion, while your son's symptoms could potentially indicate a form of epilepsy, a definitive diagnosis can only be made through a thorough medical evaluation. I strongly encourage you to consult with a pediatric neurologist to ensure that your son receives the appropriate care and management for his condition. Early intervention can significantly improve outcomes and help manage symptoms effectively. Your proactive approach in seeking answers is commendable, and I wish you and your son all the best in navigating this situation.

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