A clinical and EEG study of epilepsy with grad mal on awakening

Objective To study the clinical and EEG characteristics of epilepsy with gradmal on awakening (GMA).MethodsThe clinical manifestations and EEG changes, as wellas prognosis were studied in 12 patients with GMA (7males and 5 females, Aged 9months～43years).The EEG was performed in all patients.ResultsIn 66% cases, the onset age ofthe seizures was 6～25 years. The seizure type was tonic-clonic seizures in all cases, whileabsence seizure was seen in 2 cases. The majority of seizures occurred either in few hours afterawakening (early morning and noon), or during the relaxation time (night and evening). Noobvious etiological factors were found in most patients, while their neurological examinationwere also normal. The sleep deficiency and termination were common inducements. The mostfrequent findings in EEG were increased slow waves (91%), which showed no focal abnormalities.Generalized epileptic discharge (including sharp wave and spike-wave) was recorded in 25%patients. Seizures in 62%(5/12) patients were completely controlled with only one antiepilepticdrugs, four of them were controlled with valproic acid (VPA), but 1 of those relapse afterCessation of treatment. Topiramate was found effective in 1 of 2 patients. Seizures werecontrolled over 3 months in 3 patients with multiple drug therapy.ConclusionMostpatients?Character coincides with literature. VPA is effective, Topiramate may be effective.In patients when the seizures are resistant to the single drug, multiple drug would be apromising alternative.[