Neuro

Question 1

How is juvenile myoclonic epilepsy (JME) treated?

Answer 1

Valproic acid is first line. Also counsel about avoidance of alcohol and good sleep hygiene.

Question 2

How is juvenile myoclonic epilepsy diagnosed?

Answer 2

Electroencephalogram: bilateral polyspike & slow wave activity

Question 3

What is first line therapy for Parkinson’s disease?

Answer 3

Levodopa or dopamine agonists (eg, pramipexole, bromocriptine) are typically used for the initial treatment of Parkinson disease (PD) symptoms. Levodopa is the most effective in controlling symptoms, but there are potential concerns regarding its prolonged use. Levodopa may hasten destruction of substantia nigra cells and worsen symptoms in the long-term. There might also be a limited period of response to levodopa and a higher incidence of levodopa-related dyskinesia in patients with early-onset PD. Consequently, some experts favor levodopa in patients age >65 who have severe symptoms affecting their quality of life. Dopamine agonists such as pramipexole can help to save levodopa treatment for a later time when the patient’s symptoms are more severe, and it might be preferred as the initial treatment in patients age <65.