Myoclonus is an episode of sudden, brief, involuntary twitching or jerking. A harmless form of myoclonus is the hiccups. The twitching or jerking is uncontrollable. Myoclonus is not a disease itself, more a symptom of an underlying condition, or a result of something else. The twitching and jerking can affect only one muscle or all over the body.
If you have positive myoclonus it causes your muscles to flex. Negative myoclonus causes your muscles to suddenly relax.
Types Of Myoclonus
There are different types of myoclonus. Action myoclonus is triggered by movement, it affects the arms, legs, face, and voice. Physiological is when there are no other underlying problems that are causing the myoclonus episodes. Hiccups are an example of physiological myoclonus. So are spasms when you fall asleep, or twitches when you are startled.
- Symptomatic myoclonus is when it is caused by another underlying condition. Stimulus- sensitive myoclonus is when the twitches or jerks are triggered by lights, noise, or movement.
- Brainstem myoclonus is when your twitches and jerks are triggered by a sudden noise or something you see that makes your body flex. Usually affects the elbows, knees, or neck.
- Cortical reflex myoclonus is thought to be a type of epilepsy that causes the upper limbs or face to flex.
- Palatal myoclonus causes tremors in the roof of the soft palate of the mouth. Tremors come fast and you can have up to 150 tremors per minute. Palatal myoclonus can affect the face, tongue, diaphragm, and throat. It can also cause you to have trouble speaking, or eating.
- Reticular reflex is when the twitching or jerking happens throughout the whole body.
- Sleep myoclonus is when spasms occur while you are sleeping. This can happen in the lips, eyes, fingers, or toes.
- Epileptic myoclonus occurs as a symptom of epilepsy.
- Progressive myoclonus epilepsy is a type of epileptic myoclonus.
- Essential myoclonus becomes more severe over time. It usually runs in families. The only symptom is that there are twitches or jerks and no other symptoms.
Symptoms Of Myoclonus
The main symptoms of myoclonus are jerks, shakes or spasms. These jerks, shakes, or spasms can be sudden, brief, involuntary, uncontrollable, shock-like, vary in intensity, vary in frequency, are isolated to one part of your body, affect the whole body, they can interfere with eating, speaking, and walking.
Causes can be as a result of something that happened to you like an infection, stroke, trauma, tumor, kidney failure, liver failure, lipid storage disease, adverse effects of drugs and chemicals, hypoxia, or metabolic disorders.
It can also be caused by having a neurological disorder such as epilepsy, encephalitis, coma, Parkinson’s disease, Lewy body dementia, Alzheimer’s disease, Creutzfeldt-Jakob disease, paraneoplastic syndrome, corticobasal degeneration, frontotemporal dementia, or multiple system atrophy.
Diagnosis Of Myoclonus
Your doctor will want to do a full work up on you before diagnosing you with myoclonus. After a physical exam your doctor may want to do some different tests to verify what is going on. One test that he may want to do is an EEG, or an electroencephalogram. This is a test where your doctor will place sensors on the skin of your head to track and record patterns of the electrical activity in the brain. Another test is an EMG, or electromyography. This checks for the health of the muscles and the nerves connecting to the muscles. An MRI can also give your doctor a detailed picture of your brain and spinal cord if there is concern of lesion or tumor.
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Treatment & Prevention Of Myoclonus
Treatment can be hard. If you have an underlying condition leading to your myoclonus your doctor will try to treat that in hopes that it will help treat your myoclonus. In many cases you may have to take a few different medications at the same time to help stop multiple parts of the brain. Some medication options are Benzodiazepines, which is used as a muscle relaxer. Anti-seizure medications can be helpful even if you don’t have epilepsy or a seizure disorder. 5-hydroxytryptophan which are the building blocks of serotonin. Some doctors have found this to be helpful in treating myoclonus.
Botox injections can be an alternative treatment solution. Botox works at blocking the chemical receptors of the muscles so injecting them in the muscles that twitch, can stop them from twitching. Surgery to remove any lesions or tumors can also help. Another surgical option is Deep Brain stimulation. This is a surgical procedure where electrodes are positioned in the brain and connected to a device in your chest. The device in your chest sends out signals to block the twitches. This is a treatment that is usually reserved for people with Parkinson’s disease.
There is no way to prevent myoclonus. Myoclonus is a brief muscle spasm, like a twitch or a jerk. It is usually caused by underlying conditions, such as Alzheimer’s disease, dementia, or Parkinson’s disease. It can be a result of infection, stroke, or other trauma. It usually does not affect the quality of life you are living. It can in more severe cases cause you to have trouble eating, talking, or walking. There are treatment options to help control the amount of spasms you are having to keep your quality of life unaffected.
Involuntary twitching or jerking can be a sign of Myoclonus! #HealthSurgeon
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