Myoclonic seizures are brief, involuntary muscular jerks arising from the central nervous system that can occur in different
epilepsy syndromes, including idiopathic
generalized epilepsies or the most severe group of epileptic
encephalopathies.
Valproate is commonly the first choice alone or in combination with some
benzodiazepines or
levetiracetam. However, more treatment options exist today as there is emerging evidence to support the efficacy of some newer
antiepileptic drugs. In addition, of major importance remains avoidance of medications (e.g.,
carbamazepine,
phenytoin) that may aggravate
myoclonic seizures. This is an updated review on the available therapeutic options for treatment of
myoclonic seizures. Areas covered: Key efficacy, tolerability and efficacy data are showed for different
antiepileptic drugs with antimyoclonic effect, alone and/or in combination. Expert opinion: Pharmacological treatment of
myoclonic seizures is based on clinical experience with little evidence from randomized clinical trials.
Valproate,
levetiracetam, and some
benzodiazepines, are widely used. There is still insufficient evidence for the use of other antiseizure drugs, such as
topiramate or
zonisamide as monotherapy. Better understanding of pathophysiologic mechanisms of
myoclonic epilepsies could yield great improvement in the treatment and quality of life of patients.