Enhanced blink reflex recovery in juvenile myoclonic epilepsy

•Blink reflex recovers easily and quickly in juvenile myoclonic epilepsy (JME).•R2 components have longer durations and higher amplitudes in JME.•Latencies of R2 are normal in JME.•There is an enhanced excitability in the brainstem blink reflex circuitry in JME. Juvenile myoclonic epilepsy (JME), which has been attributed to the dysfunction of cortico-thalamic pathway, has been considered to be one of the system epilepsies. However, electrophysiological and functional neuroimaging techniques have revealed the functional involvement of various parts of the central nervous system, also. Here, we aimed to analyze the role of brainstem circuits in JME by using the blink reflex recovery cycle (BRrc). Electrophysiological recordings of 18 JME patients together with age and gender matched 18 healthy subjects were made during single and paired supraorbital stimulation. Constant current paired stimuli were delivered at interstimulus intervals (ISI) of 200 and 400ms. Amplitudes of R2 responses were measured on the non-dominant side, and percentages of the recovery cycles were calculated. All participants had normal and similar R1 and R2 components of blink reflex (BR). At ISI of 400ms, R2 recoveries were significantly higher in the JME group compared to healthy subjects (p=0.040). There was no correlation between R2-BRrc and ages of JME patients, disease duration and daily dosage of valproic acid. We suggest that in JME, the integrity of BR circuit is preserved while the excitability of the brainstem BR circuitry is enhanced.