A myoclonus is a short, lightning-like contractions of a muscle or muscle group. The diagnosis is made clinically and sometimes electromyography confirmed. The treatment involves the removal of reversible causes and, if necessary, oral medications to alleviate the symptoms.

myoclonus can

A myoclonus is a short, lightning-like contractions of a muscle or muscle group. The diagnosis is made clinically and sometimes electromyography confirmed. The treatment involves the removal of reversible causes and, if necessary, oral medications to alleviate the symptoms. Myoclonus may Focal Segmental (contiguous areas) Multifocal (noncontiguous areas) Generalized seizures It may be physiological or pathological. A physiological myoclonus may occur when a person falls asleep straight, and during earlier stages of sleep (so-called. Hypnischer myoclonus). A hypnischer myoclonus may be focal, multifocal, segmental or generalized and resemble a startle response. Another form of physiological myoclonus is the hiccup (diaphragmatic myoclonus). A pathological myoclonus may originate from various diseases and drugs (see table: causes of myoclonus). The most common causes are hypoxia drug toxicity metabolic disorders Other causes include degenerative diseases of the basal ganglia and some dementias. Causes of myoclonus cause degeneration of the basal ganglia examples dementia with Lewy bodies Huntington’s Parkinson’s disease Progressive supranuclear palsy dementia Alzheimer’s disease Creutzfeldt-Jakob disease Progressive myoclonic encephalopathy (z. B. mitochondrial disease, certain forms of epilepsy as sialidosis, neuronal ceroid lipofuscinosis and Unverricht-Lundborg disease) Metabolic disorders hypercapnia Hypergl ykämie, nichtketotisch hypocalcemia hypoglycemia hypomagnesemia hyponatremia liver failure uremia Physical and hypoxic encephalopathy electrocution heatstroke hypoxia traumatic brain injury Toxic encephalopathies DDT heavy metals (incl. Bismuth) methyl bromide viral encephalopathies encephalitis lethargica herpes simplex Enzephalititis Postinfective encephalitis Subacute sclerosing panencephalitis Pharmacotherapy Antihistamines * carbamazepine * Cephalosporins * levodopa † Lithium * MAO inhibitors * Opioids (usually dose-dependent) penicillin * phenytoin * Tricyclic antidepressants * SSRI * valproate * * In case of toxic or high doses. † For long-term treatment; dose-dependent. DDT = Dichlorodiphenyltrichlorethan; MAO = monoamine oxidase. Symptoms and signs A myoclonus can respect. Vary amplitude, frequency and distribution. Muscle spasms can occur spontaneously or be triggered by a stimulus (eg. B. sudden noise, motion, light, visual stimulus). A myoclonus, which occurs when patients are suddenly startled (startle myoclonus), may be an early symptom of Creutzfeldt-Jakob disease. A myoclonus due to a severe closed head trauma or a hypoxic-ischemic brain damage can at voluntary movements worsen (Aktionsmyoklonus) or spontaneously occur if the movements are restricted due to injury. A myoclonus by metabolic disorders may be multifocal, asymmetric, and induced by a stimulus; generally comprising the proximal face or leg muscles. If the fault persists, generalized myoclonic jerks, and ultimately seizures may occur. Diagnosis Clinical Investigation The diagnosis of myoclonus is clinical. The testing is based on the clinically suspected causes. Treatment correction of metabolic disorder or other cause, if possible, discontinuing or reducing the dose of the causative drug Drug therapy to relieve symptoms Treatment of myoclonus begins with the correction of the underlying metabolic disorders or other causes, provided they are correctable. When a drug is suspected as the cause, it will be discontinued or the dose reduced. For relief of symptoms is clonazepam 0.5-2 mg po 3 times / day often effective. Valproate 250-500 mg p.o. 2 times / day or levetiracetam 250-500 mg po one to two times / day can be effective; rarely help other anticonvulsants. The dosage of clonazepam or valproate may need to be lower in the elderly. Many Myoklonusformen talking on the serotonin precursor of 5-hydroxytryptophan (initial 25 mg po 4 times / day, increased to 150-200 mg PO 4 times / day), which must be given together with the oral decarboxylase inhibitor carbidopa ( 50 mg every morning and 25 mg or 50 mg at noon every night and 25 mg at night). Conclusion A myoclonus is a brief flash of muscle contraction that regard. May vary severity and distribution. A myoclonus may be physiologically (z. B. hiccups, sleep-related muscle contractions) or the result of various brain disorders, systemic diseases or drugs. If a metabolic disorder is the cause, correct them, and give you, if necessary, medication (eg. As clonazepam, valproate, levetiracetam) to alleviate the symptoms.

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