○ Sleep deprivation
○ Recreational drugs: Stimulants such as cocaine, amphetamines, GHB, and ketamine may exacerbate or trigger seizures and should be avoided.
○ Poor compliance: Importance of adherence to AEDs should be emphasized
○ Drug Interactions: interactions of AEDs with hormonal contraceptives.
○ Photosensitivity: Patients with photosensitive JME should be warned to avoid flashing lights, high luminescence contrast, or rapidly changing images, such as the stroboscopic light effects of clubs, some television programs, and video games.
○ First line: Valproate
○ Levetiracetam and lamotrigine are preferred first-line options for young women, in view of the high teratogenic risk of valproate.
○ Drugs to be avoided in JME are carbamazepine, phenytoin, and oxcarbazepine, which can exacerbate absences and myoclonic jerks.
○ When access to treatment is limited or too costly, phenobarbital can be used
Source: Current Treatment Options in Neurology (2011) 13:355–370
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Dr. Harvinder Singh, M.D. (Admin)
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