Myoclonus

The myoclonic twitches or jerks are usually caused by sudden muscle contractions; they also can result from brief lapses of contraction. Myoclonus is similar to sudden muscle cramps, but muscle contractions begin and end more rapidly, lasting only moments. The muscle that separates the chest from the abdomen. Myoclonus refers to a quick, involuntary muscle jerk. For example, hiccups are a form of myoclonus. The most common time for people to encounter them is while falling asleep ("sleep starts"), but myoclonic jerks are also a symptom of a number of neurological disorders . Myoclonus may occur normally, often when a person is falling asleep. Or it may result from a disorder such as liver or kidney failure.

Myoclonus may occur normally, often when a person is falling asleep These forms of myoclonus occur in healthy people and rarely present a problem. . Examples of normal myoclonus include hiccups and an occasional leg movement while falling asleep. Some occur normally These forms of myoclonus occur in healthy people and rarely present a problem. Myoclonic jerks may occur alone or in sequence, in a pattern or without pattern. Segmental myoclonus is a rare manifestation of a focal spinal cord lesion. It may also be the clinical expression of epilepsia partialis continua, a disorder in which a repetitive focal epileptic discharge arises in the contralateral sensorimotor cortex, sometimes from an underlying structural lesion. Myoclonus may be severely disabling, particularly when it is triggered by movement.

In some cases, it may also be very mild. An electroencephalogram is often helpful in clarifying the epileptic nature of the disorder, and CT or MRI scan may reveal the causal lesion. Myoclonus in one or both legs during the night is known as Noctural Myoclonus or Restless Leg Syndrome (RLS) and can also occur in the absence of any other disease. Myoclonic jerks are often seen during epileptic siezures.

Myoclonus following anoxic brain damage is often responsive to oxitriptan (5-hydroxytryptophan), an investigational agent that is the precursor of serotonin, and sometimes to clonazepam. In its simplest form, myoclonus consists of a muscle twitch followed by relaxation. More severe cases of myoclonus can distort movement and severely limit a person's ability to eat, talk, or walk. These types of myoclonus may indicate an underlying disorder in the brain or nerves.

Here is the list of some of the causes of myoclonus disorder :

• certain types of seizure disorders (progressive myoclonic epilepsy),
• degenerative diseases that occur late in life (such as Alzheimer's disease),
• prion diseases (such as Creutzfeldt-Jakob disease),
• and head injuries.

Cause of Myoclonus

Here are the list of the possidleCause of Myoclonus:

• Myoclonus may develop in response to infection, head or spinal cord injury , stroke , brain tumors , kidney or liver failure , lipid storage disease , chemical or drug poisoning , or other disorders.
• The electrical discharge may originate in the brain, the spinal cord, or a nerve in the body
• A lack of oxygen or nutrients
• Certain medications or toxins
• Lipid storage disease (usually occurs in children, it is a congenital disorder)
• People with a seizure disorder are more likely to have a seizure when they are under excess physical or emotional stress or deprived of sleep.
• Tumors of the brain or spinal cord.

Symptoms of Myoclonus

Some sign and symptoms related to Myoclonus are as follows:

• In someone with epilepsy, myoclonic seizures cause abnormal movements on both sides of the body at the same time. In reflex epilepsies, myoclonic seizures can be brought on by flashing lights or other environmental triggers.
• In about 20% of people who have a seizure disorder, seizures are preceded by unusual sensations of smell, taste, or vision or an intense feeling that a seizure is about to begin (aura).
• Symptoms vary depending on which area of the brain is affected by the abnormal electrical discharge (see Biology of the Nervous System : Brain and Brain Dysfunction : Dysfunction by Location ).
• It may be limited to one region of the body or affect all muscle groups. Light, sound, touch, or movement may be triggers
• Basal ganglia degenerations

Treatment of Myoclonus

Myoclonus may respond to certain anticonvulsant drugs, especially valproic acid, or to one of the benzodiazepines, particularly clonazepam (Table 24–3). It may also respond to piracetam (up to 16.8 g daily). Hiccups are a type of myoclonus that involves only the diaphragm, the muscle that separates the chest from the abdomen. Myoclonus may also involve many muscles at the same time. Treating myoclonus is easiest when a reversible underlying cause can be found, such as a medication or toxin that can be discontinued or flushed out, a metabolic abnormality that can be corrected or a spinal lesion that can be removed. Juvenile myoclonus epilepsy usually responds to valproate, and may require life-long treatment. Symptomatic treatment usually includes benzodiazepines such as clonazepam or diazepam. Treatment of Myoclonus are as follows:

• Treatment of myoclonus focuses on medications that may help reduce symptoms.
• Many of the drugs used for myoclonus, such as barbiturates , phenytoin and primidone , are also used to treat epilepsy
• This is usually done with medications.
• Lorazepam (Ativan)
• Divalproate sodium (Depakote)
• Carbamazepine (Tegretol)
• Surgery may be an option to remove a lesion on the spine that's causing myoclonus.
• There are no drugs specifically designed to treat myoclonus, but doctors have borrowed from other disease treatment arsenals to relieve myoclonic signs and symptoms.

Types of Myoclonus

There are many types of Myoclonus depending upon the causes, symptoms, effects, and responses to therapy. Listed below are some common forms of Myoclonus:

Action myoclonus which is a very common type of myoclonus which is mainly caused by brain damage that results from a lack of oxygen and blood flow to the brain when breathing or heartbeat is temporarily stopped. This type mainly affect the arms, legs, face, and even the voice.

Cortical reflex myoclonus - In this type of myoclonus, jerks usually involve only a few muscles in one part of the body, but jerks involving many muscles also may occur. Cortical reflex myoclonus can be intensified when patients attempt to move in a certain way or perceive a particular sensation.

Essential myoclonus - In this type of myoclonus, there is not a definete cause of it, but it can occur randomly in people with no family history, but it also can appear among members of the same family, indicating that it sometimes may be an inherited disorder.

Palatal myoclonus is a minor condition mainly appears in adults and can last indefinitely.People with palatal myoclonus usually regard it as a minor problem, although some occasionally complain of a "clicking" sound in the ear, a noise made as the muscles in the soft palate contract.

Stimulus-sensitive myoclonus is triggered by a variety of external events, including noise, movement, and light. Surprise may increase the sensitivity of the patient.

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