Myoclonus

Overview

Myoclonus is a medical condition characterized by sudden, involuntary jerking movements or shock-like sensations that are brief, variable in intensity and frequency, and can occur in one part of the body or all over the body. These movements are usually sudden, brief, and uncontrollable. Myoclonus can occur in healthy individuals, such as hiccups or "sleep starts," but it can also be a symptom of underlying nervous system disorders, metabolic conditions, reactions to medications, or other medical problems. Treatment of myoclonus primarily focuses on addressing its underlying cause, with the goal of improving quality of life. If myoclonus symptoms become frequent and persistent, it is recommended to consult a healthcare provider for a diagnosis and discussion of appropriate treatment options.

Understanding the disease

Symptoms

The symptoms of myoclonus include sudden, brief, involuntary, shock-like jerking movements that can vary in intensity and frequency. These movements can occur in one part of the body or all over the body. Myoclonus can sometimes be severe enough to interfere with eating, speaking, or walking. If the symptoms become frequent and persistent, it is advisable to consult a healthcare provider for a diagnosis and treatment options.

Development

The various forms of myoclonus can develop due to different underlying causes, which help determine the treatment approach. As mentioned, myoclonus can be separated into different types based on the cause:

1. Physiological myoclonus: This type of myoclonus occurs in healthy people and rarely requires treatment. Examples include hiccups, sleep starts, shakes or spasms due to anxiety or exercise, and infant muscle twitching during sleep or after a feeding.
2. Essential myoclonus: This type of myoclonus occurs on its own, usually without other symptoms and without being related to any underlying illness. The cause of essential myoclonus is often unknown. In some cases, the cause is hereditary, meaning passed down in families.
3. Epileptic myoclonus: This type of myoclonus occurs as part of an epileptic disorder.
4. Symptomatic myoclonus (secondary myoclonus): This type of myoclonus results from an underlying medical condition. Examples include head or spinal cord injury, infection, kidney or liver failure, lipid storage disease, chemical or drug poisoning, prolonged oxygen deprivation, medicine reaction, autoimmune inflammatory conditions, metabolic disorders, and Coronavirus disease 2019 (COVID-19). Nervous system conditions that result in secondary myoclonus include stroke, brain tumor, Huntington's disease, Creutzfeldt-Jakob disease, Alzheimer's disease, Parkinson's disease and Lewy body dementia, corticobasal degeneration, frontotemporal dementia, and multiple system atrophy. Treating the underlying condition causing myoclonus can help control symptoms. In cases where the cause is unknown or cannot be specifically treated, the goal of treatment is to reduce the impact of myoclonus on the individual's quality of life.

Assessment and Diagnosis

Triage

If myoclonus symptoms become frequent and persistent, it is advisable to consult a healthcare provider for a diagnosis and treatment options.

Diagnosis

To diagnose myoclonus, a health care provider will review your medical history and symptoms, and conduct a physical examination. Tests may be performed to find the cause of myoclonus and rule out other potential causes. These tests may include electroencephalography (EEG), electromyography (EMG), laboratory tests, and imaging tests such as magnetic resonance imaging (MRI). Genetic testing may also be suggested to identify possible causes of myoclonus. The goal of treatment is to stop the problem causing myoclonus, and if that's not possible, to reduce symptoms. Medications may be prescribed, and therapies such as Botox injections or surgery may be considered in certain cases.

Management and Treatment

Treatment

Treatments for myoclonus depend on the underlying cause. Some forms of myoclonus, such as physiological myoclonus, may not require treatment if they are not causing significant disturbances. However, other forms of myoclonus may require treatment to manage symptoms and improve quality of life.

1. Essential myoclonus: Treatment for essential myoclonus is often challenging since the cause is unknown and hereditary. There is no specific treatment for this type of myoclonus, but medications may be prescribed to help manage symptoms.
2. Epileptic myoclonus: Treatment for epileptic myoclonus typically involves managing the underlying epilepsy. Anti-seizure medications are usually prescribed to control myoclonus symptoms.
3. Symptomatic myoclonus: The treatment for symptomatic myoclonus focuses on addressing the underlying medical condition causing the myoclonus. Depending on the specific cause, treatment options may include medications, surgery, physical therapy, or lifestyle changes. In some cases, a combination of treatments may be used to manage myoclonus symptoms effectively. It is important to consult with a healthcare provider to determine the appropriate treatment plan based on the individual's specific situation and underlying cause of myoclonus. It is always advisable to consult a healthcare professional for personalized medical advice and treatment options.

Preparing for medical consultation

To prepare for an appointment for myoclonus, you should:

1. Be aware of any pre-appointment restrictions: At the time you make the appointment, ask if there's anything you need to do in advance, such as restricting your diet.
2. Write down any symptoms you're experiencing: Include all symptoms, even those that may seem unrelated to myoclonus.
3. Write down key personal information: Note any major stresses, recent life changes, or family history that could be relevant to your condition.
4. Make a list of all medications, vitamins, or supplements you're taking: This can help your healthcare provider understand your overall health and potential interactions.
5. Consider bringing a family member or friend: Having someone with you can help you remember important information and serve as an advocate for your needs.
6. Gather relevant medical records: Bring any previous scans, X-rays, reports, and other important medical records to the appointment.
7. Prepare a list of questions: Write down questions about possible causes, treatments, and prognosis for your myoclonus. Remember to be open and honest with your healthcare provider about your symptoms and concerns. This will help them provide the best care and guidance for your situation.