Classification systems use terminology and concepts of seizure onset to organize knowledge of the types of epilepsy. Lateralizing features are not uncommon in generalize seizures and definitions to distinguish focal and generalized seizures have been recently been revised1. In this case, “pseudo-resistance” to AEDs occurred from misclassification and inappropriate drug selection. Generalized (genetic) epilepsy syndromes such as Juvenile Myoclonic Epilepsy may not respond to narrow-spectrum AEDs used to treat focal seizures or provoke new types of seizures (myoclonic jerks) as in this case. AED substitution with lamotrigine led to complete control of all seizures.
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