Juvenile myoclonic epilepsy and narcolepsy: A series of three cases.
OBJECTIVE
This paper sets out to demonstrate the coexistence of juvenile myoclonic epilepsy (JME) and narcolepsy that raises the possibility of a shared genetic predisposition to both conditions.


METHODS
The electronic medical records (EMRs) were searched for narcolepsy and JME over 10years.


RESULTS
We identified three young adult women diagnosed with JME in their teenage years, with myoclonic, generalized tonic-clonic, and absence seizure semiologies, along with psychiatric comorbidity, well managed on lamotrigine and/or levetiracetam. Our patients were also found to have disturbed sleep preceding the diagnosis of JME by many years, including excessive daytime sleepiness (EDS), fragmented nocturnal sleep, hypnagogic vivid hallucinations, and REM behavior disorder along with daytime cataplexy. They were ultimately diagnosed with coexisting narcolepsy, confirmed by sleep studies and multiple sleep latency testing, along with positive genetic testing for HLA-DQB1*0602 in all three patients. Stimulants, selective serotonin receptor inhibitors, and/or sodium oxybate were used to successfully treat their narcolepsy.


CONCLUSIONS
The coexistence of JME and narcolepsy has not been well recognized and may be clinically relevant. In addition, it raises the possibility of a shared genetic predisposition to both conditions.
Department of Neurology, New York University Langone School of Medicine, New York, NY 10016, USA.
Puja Aggarwal
PA
Joshi
Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
Annapurna
A
Poduri
Comprehensive Epilepsy Center, Department of Neurology, New York University Langone Medical Center, New York, NY 10016, USA. Electronic address: Sanjeev.Kothare@nyumc.org.
Sanjeev V
SV
Kothare
D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006212:Hallucinations / Q000150:complications / Q000175:diagnosis / Q000235:genetics; D006801:Humans; D020190:Myoclonic Epilepsy, Juvenile / Q000150:complications* / Q000175:diagnosis* / Q000235:genetics; D009290:Narcolepsy / Q000150:complications* / Q000175:diagnosis* / Q000235:genetics; D020187:REM Sleep Behavior Disorder / Q000150:complications / Q000175:diagnosis / Q000235:genetics; D055815:Young Adult
Chromosome 6; Chromosomes; Epilepsy; Genetic linkage; Juvenile myoclonic epilepsy; Narcolepsy