Description

Myoclonus refers to a quick movement of shaking that you cannot control. Hiccups are a form of myoclonus, as are the sudden jerks or "sleep starts" that you may feel just before falling asleep. These forms of myoclonus occur in healthy people and in general it is not serious.

Other forms of myoclonus may occur because of a nervous system disorder, such as epilepsy, a metabolic condition, or a reaction to a medication.

The treatment of any condition, the myoclonus may help to control the symptoms. Sometimes, the cause of myoclonus is unknown or cannot be treated specifically. In these cases, the goal of treatment is to reduce the effects of myoclonus in the quality of life.

Symptoms

People with myoclonus often describe their symptoms, such as shaking, tremors or spasms, which are:

  • Sudden
  • Brief
  • Involuntary
  • Shock-as
  • Variable in intensity and frequency
  • That happens in one part of the body or the whole body
  • Sometimes severe enough to interfere with eating, speaking, or walking

When to see a doctor

If your myoclonus symptoms become frequent and persistent, talk with your health care provider regarding diagnosis and treatment options.

Causes

Myoclonus can be caused by a variety of underlying problems. It is commonly divided into different types depending on what is causing it. The cause can help determine the treatment.

Physiological myoclonus

This type of myoclonus occur in healthy people and rarely requires treatment. Examples include:

  • The hiccups.
  • The dream begins.
  • Shakes or spasms due to anxiety or exercise.
  • Baby muscle spasm during sleep or after a meal.

The myoclonus essential

Essential myoclonus occurs on its own, usually without other symptoms, and without being related to any underlying disease. The essential cause of myoclonus is often unknown. In some cases, the cause is hereditary, meaning that they are passed down in families.

Myoclonic epilepsy

This type of myoclonus occurs as part of an epileptic disorder.

Symptomatic myoclonus

Symptomatic myoclonus results of an underlying medical condition. It is sometimes called secondary myoclonus. Examples include:

  • Head or spinal cord injury.
  • Infection.
  • Renal or hepatic insufficiency.
  • Lipid storage disease.
  • Chemical or drug poisoning.
  • Prolonged oxygen deprivation.
  • The medicine of the reaction.
  • Autoimmune inflammatory conditions.
  • Metabolic disorders.
  • Coronavirus disease 2019 (COVID-19).

Conditions of the nervous system that result in secondary myoclonus include:

  • Stroke.
  • Tumor in the brain.
  • Huntington's disease.
  • Creutzfeldt-Jakob disease.
  • Alzheimer's disease.
  • Parkinson's disease and dementia with Lewy bodies.
  • Degeneration Corticobasal.
  • Frontotemporal dementia.
  • The multiple system atrophy.

Diagnosis

To diagnose the myoclonus, your health care provider to review your medical history and symptoms and perform a physical examination.

You may have tests to find the cause and rule out other possible causes of myoclonus. In some cases, imaging tests, and nerve tests may be needed.

  • Electroencephalography (EEG). This procedure that records the electrical activity of the brain. You can help determine where in the brain the myoclonus originated. In the first place, the small electrodes are placed on the scalp. Then you can ask them to breathe deeply and steadily and look at bright lights or listen to the sounds. These actions can discover the electrical activity spot.
  • Electromyography (EMG). In this procedure, electrodes are placed on the muscles, especially the muscles that are involved in the shocks. An instrument that records the electrical activity of the muscles when they are at rest, and when they are contracted, such as when you bend the arm. These signals help to determine the pattern and the origin of the myoclonus.
  • Evoked potential studies. These tests measure the electrical activity of the brain, brainstem and spinal cord that are activated by touch, sound, sight, and other stimuli.
  • Magnetic resonance imaging (MRI). A magnetic resonance imaging can be used to check for structural problems or tumors in the brain or in the spinal cord, which can cause myoclonus symptoms. An mri uses a magnetic field and radio waves to produce detailed images of the brain, spinal cord, and other areas of the body.
  • The laboratory tests. Your doctor may suggest genetic testing to help identify possible causes of myoclonus. Blood or urine tests may be needed to check for metabolic disorders, autoimmune diseases, diabetes, and kidney or liver disease. You can also check for drugs or toxins.

Electromyography (EMG) . In this procedure, electrodes are placed on the muscles, especially the muscles that are involved in the shocks.

An instrument that records the electrical activity of the muscles when they are at rest, and when they are contracted, such as when you bend the arm. These signals help to determine the pattern and the origin of the myoclonus.

Treatment

The treatment of myoclonus works bets if you can stop the problem that is causing it. For example, treatment may focus on another condition, a medication, or a toxin that causes myoclonus.

Most of the times, however, the underlying cause cannot be cured or eliminated. In these cases, treatment is aimed at reducing the myoclonus symptoms, especially when they are very disabling. There are No medications specifically designed for the treatment of myoclonus. But treatments for other diseases that may help relieve myoclonus symptoms. More than one medication may be necessary to control symptoms.

Drugs

The drugs that the health care providers who are commonly prescribed for the myoclonus include:

  • Tranquilizers. Clonazepam (Klonopin), a tranquilizer, is the most common drug used to treat myoclonus symptoms. Clonazepam can cause side effects such as loss of coordination and drowsiness.
  • Anticonvulsants.Medications used to control epileptic seizures may help to reduce the myoclonus symptoms. The most common anticonvulsants used for myoclonus are levetiracetam (Keppra, Elepsia XR, Spritam), valproic acid, zonisamide (Zonegran, Zonisade), and primidone (Mysoline). Piracetam is another anticonvulsant that has been found to be effective, but it is not available in the united States. Valproic acid may cause side effects such as nausea. Levetiracetam can cause side effects such as fatigue and dizziness. Side effects of methotrexate can include sedation and nausea.

Anticonvulsants. Medications used to control epileptic seizures may help to reduce the myoclonus symptoms. The most common anticonvulsants used for myoclonus are levetiracetam (Keppra, Elepsia XR, Spritam), valproic acid, zonisamide (Zonegran, Zonisade), and primidone (Mysoline). Piracetam is another anticonvulsant that has been found to be effective, but it is not available in the united States.

Valproic acid may cause side effects such as nausea. Levetiracetam can cause side effects such as fatigue and dizziness. Side effects of methotrexate can include sedation and nausea.

Therapies

OnabotulinumtoxinA (Botox) injections may help treat various forms of myoclonus, especially if only a single affected area. This treatment blocks the release of a chemical messenger that triggers muscle contractions.

Surgery

If myoclonus symptoms are caused by a tumor or lesion in the brain or in the spinal cord, surgery may be an option. People with myoclonus affecting the parts of the face or the ear may also benefit from surgery.

Deep brain stimulation has been tested in some people with myoclonus and other movement disorders. The electrodes are implanted within certain areas of the brain. The electrodes produce electrical signals to block the pulse irregular, which can cause myoclonus. Researchers continue to study deep brain stimulation for the myoclonus.

Preparing for your appointment

Probably the first to discuss your concerns with your primary care provider. Your provider can then refer you to a neurologist. A neurologist is a specialist that is trained in nervous system conditions.

Because appointments can be brief, and because there's often a lot to talk about, it is a good idea to get well prepared for your appointment. Here's some information to help you prepare for your appointment and know what to expect.

What you can do

  • Be aware of any pre-appointment restrictions, and ask if there's something you need to do beforehand.
  • Write a list of your symptoms, and then seeing if there is something that seems to trigger or make them better.
  • Bring a list of all your medications, including any vitamins or supplements.
  • Write questions to ask their health care provider, wondering about the possible causes, treatments, and prognosis.

Your time with your doctor is limited, so preparing a list of questions in advance will help you make the most of your time together. For myoclonus, some basic questions to ask include:

  • What is the most likely cause of my symptoms?
  • Other that the most likely cause, what are other possible causes of the symptoms?
  • What kinds of tests do I need?
  • Is my condition likely temporary or chronic?
  • What is the best course of action?
  • What are the alternatives to the primary approach you're suggesting?
  • I have other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend to visit?

In addition to the questions you have prepared, do not hesitate to ask questions during your appointment anytime you don't understand something.

What to expect from your doctor

Your health care provider is likely to ask a series of questions. Be prepared to respond to them can make the time to go over any points you want to discuss it in depth. You can ask:

  • When did you first start having symptoms?
  • Do you have a history of seizures or other neurological conditions?
  • Have been exposed to drugs or chemicals?
  • Do you have a family history of myoclonus or epilepsy?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • Is there something to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
The symptoms and treatment of Myoclonus