24. Juvenile Myoclonic Epilepsy and Other Primary Generalized Epilepsies

  1. John W. Miller MD, PhD Director, UW Regional Epilepsy Center, Professor of Neurology and Neurological Surgery2 and
  2. Howard P. Goodkin MD, PhD The Shure Professor of Neurology and Pediatrics, Director, Division of Pediatric Neurology3
  1. Shahin Hakimian

Published Online: 10 JAN 2014

DOI: 10.1002/9781118456989.ch24



How to Cite

Hakimian, S. (2014) Juvenile Myoclonic Epilepsy and Other Primary Generalized Epilepsies, in Epilepsy (eds J. W. Miller and H. P. Goodkin), John Wiley & Sons, Oxford. doi: 10.1002/9781118456989.ch24

Editor Information

  1. 2

    University of Washington, Seattle, WA, USA

  2. 3

    Department of Neurology, University of Virginia, Charlottesville, VA, USA

Author Information

  1. Department of Neurology, UW Regional Epilepsy Center, University of Washington, Seattle, WA, USA

Publication History

  1. Published Online: 10 JAN 2014
  2. Published Print: 14 FEB 2014

ISBN Information

Print ISBN: 9781118456941

Online ISBN: 9781118456989



  • juvenile myoclonic epilepsy;
  • juvenile absence epilepsy;
  • primary generalized tonic–clonic seizures upon awakening;
  • progressive myoclonic epilepsy;
  • antiepileptic drugs;
  • vagus nerve stimulator


Primary generalized epilepsy syndromes, including juvenile myoclonic epilepsy, juvenile absence epilepsy, and generalized tonic–clonic seizures upon awakening, are relatively common. These syndromes present in adolescents to young adults with myoclonus or twitches, staring episodes, or generalized convulsions, but there is significant overlap among them. Neurological examination and imaging are usually normal although family history is often positive. These syndromes are characterized by their electroencephalogram (EEG) findings. Recognizing these syndromes helps define their prognosis, which is generally good, although lifelong medication treatment is often recommended. These clinical features help separate primary generalized epilepsy syndromes from other types of epilepsies including focal onset seizures, symptomatic generalized epilepsies, and progressive myoclonic epilepsies. Making the correct diagnosis is particularly important since some antiepileptic drugs can paradoxically exacerbate primary generalized epilepsy syndromes.