Myoclonic Jerks in Children with EMAS Epilepsy - Neurology

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Understanding myoclonic jerks in children with EMAS (Epileptic Myoclonic Astatic Seizures) epilepsy can be quite complex, especially when the child is experiencing these jerks during wakefulness. EMAS is a form of epilepsy that typically presents in early childhood and is characterized by myoclonic jerks, atonic seizures, and developmental delays. In your case, your child has been diagnosed with EMAS and is currently on medications such as Depakine (valproate) and Keppra (levetiracetam) to manage the seizures.

Myoclonic jerks are brief, shock-like muscle contractions that can occur in various forms of epilepsy. They can happen during sleep or wakefulness and may be triggered by various factors, including fatigue, stress, or even certain stimuli. In the context of EMAS, these jerks are often a hallmark of the condition, but their manifestation can vary significantly from one child to another.

From your description, it seems that your child experiences these myoclonic jerks while awake, which can understandably be distressing for both the child and the parents. The fact that these jerks occur during wakefulness and are not classified as seizures by your child's neurologist suggests that they may not be directly related to epileptic activity. Instead, they could be a manifestation of the underlying neurological condition or a side effect of the medications being used.

It is essential to differentiate between myoclonic jerks and seizures, as the management and implications can differ. Seizures are typically characterized by abnormal electrical activity in the brain, which can be detected through an EEG (electroencephalogram). If the jerks are not associated with such electrical discharges, they may not be classified as seizures. Your neurologist's assessment that these jerks do not constitute seizures is crucial, as it helps guide treatment decisions.

In terms of treatment, it may be beneficial to discuss the frequency and severity of these myoclonic jerks with your child's neurologist. If they are causing significant distress or impacting your child's quality of life, adjustments to the current medication regimen or the introduction of additional therapies may be warranted. For instance, some children with similar symptoms have found relief with medications specifically targeting myoclonic jerks or other adjunct therapies.

Additionally, it is important to consider non-pharmacological strategies that may help manage the situation. Ensuring that your child has a consistent sleep schedule, minimizing stressors, and creating a calming bedtime routine can sometimes reduce the frequency of these episodes. Keeping a detailed diary of when the jerks occur, their duration, and any potential triggers can also provide valuable information to your healthcare team.

Finally, it is essential to maintain open communication with your child's healthcare providers. If you feel that your child's condition is not being adequately addressed, seeking a second opinion or consulting with a pediatric epilepsy specialist may provide further insights and options for management.

In conclusion, while myoclonic jerks in children with EMAS epilepsy can be concerning, understanding their nature and how they differ from seizures is crucial. Continuous monitoring, open dialogue with healthcare providers, and exploring both pharmacological and non-pharmacological interventions can help improve your child's overall well-being and quality of life.