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The utility of Jerk-locked back averaging technique in diagnosis of generalized myoclonic epilepsy with normal scalp EEG: A case report
RATIONALE: The diagnosis of myoclonic epilepsy and the classification of generalized or partial type may be challenging, especially when the scalp electroencephalogram (EEG) is normal. In such situation, how to apply another electrophysiological technique to begin the diagnosis and classification? T...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370162/ https://www.ncbi.nlm.nih.gov/pubmed/30653168 http://dx.doi.org/10.1097/MD.0000000000014185 |
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author | Zheng, Xiangyu Wang, Zan Liu, Chang Hu, Minghui Lv, Yudan |
author_facet | Zheng, Xiangyu Wang, Zan Liu, Chang Hu, Minghui Lv, Yudan |
author_sort | Zheng, Xiangyu |
collection | PubMed |
description | RATIONALE: The diagnosis of myoclonic epilepsy and the classification of generalized or partial type may be challenging, especially when the scalp electroencephalogram (EEG) is normal. In such situation, how to apply another electrophysiological technique to begin the diagnosis and classification? The utility of Jerk-locked back averaging technique has been described in our case. PATIENT CONCERNS: A Chinese patient (male, 21 years old) presented with frequent unilateral or bilateral shoulder-jerking. He has an epilepsy history of complex partial seizure (CPS) or secondary tonic-clonic seizure (sGTCS) for 10 years. DIAGNOSIS: After admission, scalp EEG was performed with the normal result when the patient showed the jerks. According to the patient's clinical presentation, we suspected myolconic seizure, but there was lack of objective evidence. Then we used Jerk-locked back averaging technique to help begin the diagnosis. A bilateral-symmetrical time-locked, evoked cortical averaging potential that preceded the jerk has been found. So the jerks were considered as cortical origin and generalized myoclonic seizure was confirmed. INTERVENTIONS: So in this situation, we added another antiepileptic drug of Levetiracetam (1500 mg/24 h). OUTCOMES: One week later, the jerk seizure had disappeared, and in the following visit, he had an improved prognosis with decreased seizure frequency. LESSONS: Generalized polyspike-slow wave in EEG was common to see in myoclonic seizure and can help to make the classification. However, it should not dissuade clinicians from the diagnosis of myoclonic epilepsy with normal scalp EEG. Under this condition, we may apply other electrophysiological technique such as Jerk-locked back averaging technique, to give objective evidence to verify the cortical origin. |
format | Online Article Text |
id | pubmed-6370162 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-63701622019-02-22 The utility of Jerk-locked back averaging technique in diagnosis of generalized myoclonic epilepsy with normal scalp EEG: A case report Zheng, Xiangyu Wang, Zan Liu, Chang Hu, Minghui Lv, Yudan Medicine (Baltimore) Research Article RATIONALE: The diagnosis of myoclonic epilepsy and the classification of generalized or partial type may be challenging, especially when the scalp electroencephalogram (EEG) is normal. In such situation, how to apply another electrophysiological technique to begin the diagnosis and classification? The utility of Jerk-locked back averaging technique has been described in our case. PATIENT CONCERNS: A Chinese patient (male, 21 years old) presented with frequent unilateral or bilateral shoulder-jerking. He has an epilepsy history of complex partial seizure (CPS) or secondary tonic-clonic seizure (sGTCS) for 10 years. DIAGNOSIS: After admission, scalp EEG was performed with the normal result when the patient showed the jerks. According to the patient's clinical presentation, we suspected myolconic seizure, but there was lack of objective evidence. Then we used Jerk-locked back averaging technique to help begin the diagnosis. A bilateral-symmetrical time-locked, evoked cortical averaging potential that preceded the jerk has been found. So the jerks were considered as cortical origin and generalized myoclonic seizure was confirmed. INTERVENTIONS: So in this situation, we added another antiepileptic drug of Levetiracetam (1500 mg/24 h). OUTCOMES: One week later, the jerk seizure had disappeared, and in the following visit, he had an improved prognosis with decreased seizure frequency. LESSONS: Generalized polyspike-slow wave in EEG was common to see in myoclonic seizure and can help to make the classification. However, it should not dissuade clinicians from the diagnosis of myoclonic epilepsy with normal scalp EEG. Under this condition, we may apply other electrophysiological technique such as Jerk-locked back averaging technique, to give objective evidence to verify the cortical origin. Wolters Kluwer Health 2019-01-18 /pmc/articles/PMC6370162/ /pubmed/30653168 http://dx.doi.org/10.1097/MD.0000000000014185 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | Research Article Zheng, Xiangyu Wang, Zan Liu, Chang Hu, Minghui Lv, Yudan The utility of Jerk-locked back averaging technique in diagnosis of generalized myoclonic epilepsy with normal scalp EEG: A case report |
title | The utility of Jerk-locked back averaging technique in diagnosis of generalized myoclonic epilepsy with normal scalp EEG: A case report |
title_full | The utility of Jerk-locked back averaging technique in diagnosis of generalized myoclonic epilepsy with normal scalp EEG: A case report |
title_fullStr | The utility of Jerk-locked back averaging technique in diagnosis of generalized myoclonic epilepsy with normal scalp EEG: A case report |
title_full_unstemmed | The utility of Jerk-locked back averaging technique in diagnosis of generalized myoclonic epilepsy with normal scalp EEG: A case report |
title_short | The utility of Jerk-locked back averaging technique in diagnosis of generalized myoclonic epilepsy with normal scalp EEG: A case report |
title_sort | utility of jerk-locked back averaging technique in diagnosis of generalized myoclonic epilepsy with normal scalp eeg: a case report |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370162/ https://www.ncbi.nlm.nih.gov/pubmed/30653168 http://dx.doi.org/10.1097/MD.0000000000014185 |
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