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Myoclonus

Overview

Myoclonus is a sudden shock-like involuntary movement, which can be sudden contraction of muscle (positive myoclonus) or a pause in muscle activity (negative myoclonus or asterixis). The following types of myoclonuses have been determined:

  • Based on distribution
    • Generalized
    • Focal
    • Multifocal
    • Segmental
  • Based on clinical presentation
    • Spontaneous
    • Action
    • Reflex (auditory, visual, or to touch)
  • Based on site of origin:
    • Cortical myoclonus- myoclonic jerks triggered by movement or stimulus-sensitive. EEG may be diagnostic: cortical discharges time-locked to myoclonic jerks; giant cortical somatosensory evoked potentials
    • Brainstem myoclonus- bilateral synchronous jerking with adduction of arms, flexion of elbows, flexion of trunk and head. Stimulus-induced: tap nose, lip, or head or loud noise
    • Spinal cord- rhythmic, repetitive, bilateral, jerking one or two adjacent parts

  • Physiological- hypnic jerks and hiccup
  • Epilepsy- focal epilepsy (Epilepsia partialis continua), myoclonic epilepsies-progressive myoclonic epilepsy (Unverricht–Lundborg disease)
  • Encephalopathy: metabolic (liver, renal failure)
  • Infections: prion diseases, HIV, SSPE
  • Post-anoxic
  • Drugs: tricyclics, L-dopa
  • Degenerative conditions: Alzheimer’s disease, MSA, corticobasal degeneration, celiac disease
  • Hereditary: HD, mitochondrial disorders, myoclonic dystonia (DYT 11), storage disorders
  • Focal lesions brain or spinal cord

  • Nervous system disorders such as multiple sclerosis, epilepsy, Parkinson's disease, Alzheimer's disease, or Creutzfeldt-Jakob disease
  • Brain or spinal cord injuries, brain tumours, or strokes
  • Infections such as meningitis or encephalitis
  • Prolonged oxygen deprivation to the brain (hypoxia)
  • Family history
  • Certain medications like anticonvulsants
  • Other conditions such as kidney or liver failure, chemical or drug intoxication, metabolic disorders, or autoimmune inflammatory conditions

Neurologist

Medical treatment is initiated per clinician’s evaluation and underlying cause

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