ABSTRACT
A 55-year-old man with Down’s syndrome was admitted to our hospital after a generalized myoclonic-tonic seizure. Approximately 3 years before admission, myoclonic jerks (particularly of the upper extremities) had started. These usually occurred in the morning and could be improved by administration of valproate (1800 mg/day). The dose was reduced because of daytime somnolence, and this reduction coincided with the occurrence of the first generalized myoclonic-tonic seizure, as described by a witness. Owing to aggressive behavior during the addition of lamotrigine, the medical regimen was not closely followed, and additional generalized myoclonic-tonic seizures occurred.
