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When the first antiepileptic drug fails in a patient with juvenile myoclonic epilepsy
  1. Andrew Nicolson1,
  2. Anthony G Marson2
  1. 1Consultant Neurologist, The Walton Centre NHS Foundation Trust, Fazakerley, Liverpool, UK
  2. 2Professor and Honorary Consultant Neurologist, The University of Liverpool, Division of Neurological Science, Clinical Sciences Centre for Research and Education, Fazakerley, Liverpool, UK
  1. Correspondence to Dr A Nicolson, The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool L9 7LJ, UK; andrew.nicolson{at}


Juvenile myoclonic epilepsy is one of the most common types of epilepsy seen in an adult epilepsy clinic. Most patients have a good prognosis, particularly when treated with valproate, but a significant minority are more difficult to treat. In this article, we will focus on a management strategy when the initial antiepileptic drug is unsuccessful and outline an approach that translates directly to the clinic.

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  • Competing interests AN and AGM have received honoraria and/or hospitality from the pharmaceutical companies that manufacture all of the drugs discussed in this article.

  • Provenance and peer review Commissioned; externally peer reviewed.

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