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Myoclonus
📖 About
- Myoclonus = sudden, involuntary muscle jerks that can vary in frequency, intensity, and distribution.
- It may be benign (e.g., sleep starts) or a sign of underlying neurological disease.
🧠 Aetiology
- Often linked to dysfunction of the basal ganglia or subthalamic nuclei.
- Can arise from structural, metabolic, epileptic, or psychogenic causes.
🔎 Causes of Myoclonus
| ⚡ Cause | 🛠️ Key Points (Investigations + Treatment) |
|---|---|
| 😴 Physiological |
✔️ Diagnosis = clinical history (sleep starts, hiccups).
✅ Reassure – benign, no treatment usually needed. |
| 🧬 Essential |
✔️ Clinical diagnosis, exclude other causes.
💊 Clonazepam, Valproate, Levetiracetam. |
| ⚡ Epileptic |
🧪 EEG & MRI brain ± genetic testing.
💊 AEDs: Valproate, Levetiracetam, Clonazepam. |
| 🧪 Secondary / Symptomatic |
🧪 MRI brain, metabolic bloods, toxicology, CSF if needed.
💊 Treat underlying cause + clonazepam/valproate. 🤸 Physiotherapy for function. |
| 🧠 Psychogenic |
❌ Diagnosis of exclusion (EEG-video monitoring helps).
🧑⚕️ Psych eval, CBT, psychotherapy ± SSRIs/anxiolytics. |
🤒 Clinical Presentation
- Sudden, brief, shock-like jerks of a muscle or group of muscles.
- Can be sporadic or repetitive.
- May be stimulus-sensitive (triggered by noise, light, or touch).
🔬 Investigations
- Basic bloods: FBC, U&E, LFTs, TFTs.
- MRI brain (structural lesions).
- EEG (epileptic myoclonus).
- CSF (e.g., 14-3-3 protein in suspected CJD).
💊 Management
- Depends on underlying cause:
- Essential/Epileptic → valproate, clonazepam, levetiracetam.
- Symptomatic → treat underlying disorder + symptomatic therapy.
- Psychogenic → psychological therapies ± pharmacological support.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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