Is this common?

[chop456]

Paige is taking 200mg (her therapeutic level) of Lamictal XR for Juvenile Myoclonic Epilepsy. She has been on this dose for about 2.5 weeks. She continues to have morning myoclonics - every do often. This morning she had 6-7 good jerks. She had 8 hours of sleep last night.

Is it common to continue to have morning myoclonics with JME and is this something Paige will "just have to deal with" or should the AED be helping to stop these, too. Perhaps she needs some time for the Lamictal to be fully in her system?

 

[Nakamova]

It could be a few different things. Paige could require a higher dose or an additional med to control the myoclonics. Or, Lamictal might be making the myoclonics worse (as has been reported in some patients taking only Lamictal.). Unfortunately there's a lot of trial and error with epilepsy meds.

If she can wait another couple of weeks, that might give a better sense of how the Lamictal is working. Make a note of the myoclonics and any other symptoms or side effects, and let the neuro know.

How is she doing otherwise?

 

[chop456]

Her myoclonics have for sure reduced since starting her meds. Prior to meds, she was having jerks 5-6 days per week - all at varying degrees. Now, she is down to every once in a while. Maybe 1 per week - at the most. Her doctor mentioned that a myoclonic every now and then could (and most likely would) happen. I was hopeful that lamictal would reduce them almost all together. Should the expectation with her AED be that myoclonics will be reduced or eliminated?

 

[Nakamova]

The expectation -- or the hope -- is that the seizures are completely controlled. But it sounds like her doctor feels like there may always be a few myoclonics that get past the meds. You could ask about trying a slightly higher dose of the Lamictal to see if that helps.