Myoclonus

A quick and involuntary jerk is called myoclonus. Other forms of myoclonus are hiccups and sleep starts that you might feel before going to sleep.

This disease rarely presents a problem and can occur in healthy people. Because of a nervous system (neurological) problem such as a reaction to a medication, epilepsy and a metabolic condition, myoclonus occurs.

Treating the underlying cause can help you control the symptoms but if the cause is unknown, the treatment is to reduce the effects of this disease.

The signs and symptoms of people who have myoclonus are:

• spasm,
• jerks,
• shakes that are involuntary, sudden, shock-like, brief, localized to one part of the body or sometimes all over the body, variable in frequency and intensity, and can interfere while speaking, eating or walking if it is severe.

Consult your doctor if your symptoms are persistent.

A variety of underlying problems can be the cause myoclonus. The types of myoclonus are divides based on their causes to determine which treatment you should have. 

The types of myoclonus are: 

• Physiological myoclonus – mostly occurs in healthy and normal people and rarely needs any treatment, it includes hiccups, sleep starts, infant muscle twitching after feeding or during sleep, spasms or shakes due to exercise or anxiety,
• Essential myoclonus – the cause of this cannot be explained (idiopathic) or hereditary, this type of myoclonus occurs on its own,
• Epileptic myoclonus – occurs as part of an epileptic disorder;
• Symptomatic (secondary) myoclonus – this are muscle jerks that occur as a result of an underlying medical condition such as:

Infection, lipid storage disease, spinal cord injury, head injury, kidney failure, liver failure, chemical poisoning, prolonged oxygen deprivation, drug poisoning, autoimmune inflammatory conditions, metabolic disorders, medical reaction, and some of the nervous system conditions such as brain tumor, stroke, Huntington’s disease, Alzheimer’s disease, Creutzfeldt-Jakob disease, Parkinson’s disease; Corticobasal degeneration, Lewy body dementia, multiple system atrophy and Frontotemporal dementia.

Consult your doctor if you suspect that you have myoclonus and he may refer you to a neurologist that specializes in nervous system conditions to receive a diagnosis. Ask your doctor if you need to do anything before the check-up. 

Bring a family member of a close friend to help you remember all the relevant information. Bring a notebook and write down the symptoms that you are experiencing. You can also write down the list of vitamins, supplements and medications that you are taking. 

Some of the questions that you can ask your doctor include:

• What is likely causing my symptoms?
• Are there other possible causes?
• What tests are available?
• Is my condition temporary or chronic?
• I also have other health conditions, how can I manage them?
• What do you think is the best action?
• What restrictions do I need to follow?
• What websites do you recommend?

Your doctor too will ask you some questions such as:

• When did the symptoms start?
• Are they severe?
• Do you or any in your family have a history of seizures or neurological problems?
• Have you been exposed to chemicals or drugs?
• Do you have a family history of myoclonus?
• Are your symptoms consistent or occasional?
• Does anything worsens or improves your condition? 

Your doctor will conduct a physical examination and will do some tests such as: 

• Electroencephalography (EEG) – this will help your doctor find out where the myoclonus originated because this procedure records the electrical activity in your brain. Small electrodes will be attached to your scalp and you will be asked to breathe steadily and deeply or look at bright lights and listen to sounds to reveal abnormal electrical activity; 
• Electromyography (EMG) – this procedure helps establish the pattern of this disease and measures the electrical discharges produced in muscles. EMG surface electrodes will be put in multiple muscles by the doctors. It will record the electrical activity and this will help to reveal the origin of myoclonus and its pattern; 
• Magnetic resonance imaging (MRI) – to check for tumors inside your spinal cord or brain and for structural problems;
• Genetic testing to identify possible cause; Urine and blood test to look for diabetes, autoimmune disease, metabolic disorders, kidney disease, drugs and toxins and liver disease.

When a reversible underlying cause can be found that can be treated (medication or toxin), myoclonus treatment can be effective. The treatment is focused on relieving of the symptoms of myoclonus. 

More than one drug may be needed because there are no drugs specifically for myoclonus.

Some medications include:

• Tranquilizers (Clonazepam or Klonopin) – the most common drug and can cause side effects such as drowsiness and loss of coordination; 
• Anticonvulsants (levetiracetam or Keppra, valproic acid or Depakene and primidone or Mysoline) – to control epileptic seizures. 
• Valproic can cause side effects such as nausea, Primidone can cause nausea and sedation, Levetiracetam can cause dizziness and fatigue. 

Therapy can also be one of the treatments like OnabotulinumtoxinA (Botox) injections to prevent muscle contractions by blocking the release of a chemical messenger. If a tumor or lesion is the cause of your myoclonus symptoms, your doctor might recommend surgery such as deep brain stimulation (DBS).

You can follow some of these preventive tips to avoid the symptoms or reduce the symptoms of myoclonus such as:

• avoid drinking alcohol,
• have at least 8 hours of sleep to lessen the stress and manage the symptoms of myoclonus,
• take care of your head to prevent brain injury.

Typical alternative remedies for myoclonus include coping strategies and counseling, relaxation techniques and anxiety reduction. 

Lifestyle modifications are necessary in order to manage the symptoms of myoclonus.

Consider these tips to relieve the symptoms or myoclonus:

getting a massage to reduce the stress and at the same time reduce the spasms;

exercise regularly to reduce anxiety due to the symptoms.

The only common risk factor of myoclonus that has been identified is a family history.

The complications of myoclonus are secondary conditions or other diseases.