title: Misdiagnosis in JME: Still a problem after 17 years?
abstract: OBJECTIVE
  Juvenile myoclonic epilepsy (JME) is one of the most common and recognizable idiopathic generalized epilepsy with its characteristic clinical and EEG features. We think despite the well defined diagnostic criteria, and increasing awareness, misdiagnosis in JME may still be a problem. The present study aims to determine misdiagnosis in JME and to compare the results with our previous study reported in 1998.
  
  
  METHODS
  Two hundred JME patients examined at epilepsy outpatient clinics of Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases between the years 2014-2015 were enrolled. Medical records of all patients were evaluated retrospectively; demographical, clinical and electrophysiological data and causes of misdiagnosis were collected from chart reviews.
  
  
  RESULTS
  Of 200 JME patients, 49 were misdiagnosed at first medical evaluation. The most common presenting seizure types were generalized tonic clonic seizure and myoclonia in misdiagnosed patients and correctly diagnosed patients, respectively. EEG revealed generalized spike wave and polyspike-wave discharges in 52% of the misdiagnosed patients. Unfortunately the physician was a neurologist in 87.8% of cases with misdiagnoses. Nearly half of 49 misdiagnosed patients were prescribed an inappropriate antiepileptic drug, and the other half were prescribed none.
  
  
  CONCLUSIONS
  Comparing our new results with the ones in 1998, misdiagnosis rate was less and time to put a correct diagnosis was shorter. However, proper diagnosis at first sight is still a problem among neurologists even the typical EEG changes are present.
authors.affiliation: Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, Department of Neurology, Zuhuratbaba-Bakirkoy 34147, Istanbul, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Atakli
authors.affiliation: Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, Department of Neurology, Zuhuratbaba-Bakirkoy 34147, Istanbul, Turkey.
authors.forename: Songul
authors.initials: S
authors.lastname: Senadim
authors.affiliation: Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, Department of Neurology, Zuhuratbaba-Bakirkoy 34147, Istanbul, Turkey.
authors.forename: Sezin Alpaydin
authors.initials: SA
authors.lastname: Baslo
authors.affiliation: Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, Department of Neurology, Zuhuratbaba-Bakirkoy 34147, Istanbul, Turkey. Electronic address: betultekin2013@gmail.com.
authors.forename: Betül Tekin
authors.initials: BT
authors.lastname: Güveli
authors.affiliation: Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, Department of Neurology, Zuhuratbaba-Bakirkoy 34147, Istanbul, Turkey.
authors.forename: Metin Dedei
authors.initials: MD
authors.lastname: Daryan
authors.affiliation: Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, Department of Neurology, Zuhuratbaba-Bakirkoy 34147, Istanbul, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Sari
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D058256:Brain Waves / Q000502:physiology; D002648:Child; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020190:Myoclonic Epilepsy, Juvenile / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: EEG; Juvenile myoclonic epilepsy; Misdiagnosis; Treatment