A young woman with recurring seizures.

A 17-year-old girl had a generalized tonic-clonic seizure (GTCS) shortly after waking up in the morning in August 2008. While waiting for a specialist visit, she had a second GTCS 3 weeks later. Family history was negative. She reported in the previous year occasional jerky movements when brushing her teeth. Neurological examination and MRI were normal and an interictal EEG showed brief bursts of generalized, bisynchronous 3.5 Hz spike or polyspike and wave discharges with predominance over the anterior regions. A diagnosis of juvenile myoclonic epilepsy (JME) was made, and she was started on lamotrigine, titrated up to 200 mg/day.