When the first antiepileptic drug fails in a patient with juvenile myoclonic epilepsy.

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.