Myoclonus – Diagnosis and Treatment
Diagnosis
Doctors begin identifying myoclonus by carefully reviewing a person’s health history, reported symptoms, and performing a detailed physical exam.
They use different types of tests to learn more about the causes and features of the involuntary movements.
Common Testing Methods
| Test Type | What It Does |
|---|---|
| Electroencephalogram (EEG) | Checks the brain’s electrical activity; useful for spotting myoclonic seizures or cortical reflex myoclonus. |
| Electromyography (EMG) | Measures muscle signals during jerks; helps tell if the myoclonus is positive (muscle contraction) or negative (pause in muscle activity). |
| MRI Scan | Shows pictures of the brain and spinal cord to find structural issues, tumors, or signs of progressive myoclonic epilepsy. |
| Evoked Potential Studies | Tests response to stimuli (touch, light, sound); helps spot if the myoclonus comes from the cortex, subcortical regions, or spinal levels. |
| Laboratory & Genetic Tests | Checks blood and urine for metabolic or autoimmune disorders; can find gene mutations linked with some types, like juvenile myoclonic epilepsy or myoclonus dystonia. |
Typical Clinical Features
- Sudden, brief jerks (myoclonic jerks) that may affect a single muscle, a group, or be more widespread.
- Myoclonic seizures, which can be rhythmic or happen without warning.
- Muscle contractions might be triggered by movement, sound, or light (stimulus-sensitive myoclonus).
- Clinicians note patterns to distinguish cortical, subcortical, essential, segmental, and spinal myoclonus types.
- In some, negative myoclonus means a brief loss of muscle tone instead of quick tightening.
Special tools, such as transcranial magnetic stimulation, also help study brain activity and cortical excitability.
The overall clinical picture—including the type of movement, age at onset, family history, and test results—guides doctors in determining if the myoclonus is isolated, caused by other conditions, or part of a syndrome like progressive myoclonic epilepsy or myoclonic epilepsy.
Treatment
Medicines Commonly Used
Doctors often prescribe several types of drugs to help control myoclonus symptoms:
Benzodiazepines: Physicians may prescribe a benzodiazepine to help calm myoclonus. This type of medication can reduce involuntary movements but may cause side effects such as drowsiness or loss of balance in some individuals.
Antiepileptic Drugs: Doctors use antiepileptic medications to help lower the frequency and strength of muscle jerks. Sometimes, doctors combine more than one medicine. They adjust the treatment plan based on how well symptoms are controlled and any adverse reactions.
Other Medications: In rare cases, physicians may use medicines like levodopa for specific types of myoclonus, depending on the underlying cause.
Other Treatments That Can Help
Clinicians may suggest botulinum toxin injections when myoclonus affects just one area of the body. These injections block signals that cause muscles to tighten or spasm.
Providers recommend this option for people who do not respond well to medicines or who have myoclonus in a single limb or muscle group.
Surgical Methods and Advanced Options
Surgeons may remove growths or injured areas in the brain or spinal cord if these cause myoclonus. Certain people might benefit from targeting these sources directly.
For those with ongoing, difficult-to-control symptoms, specialists have tried deep brain stimulation (DBS).
In DBS, thin wires are placed in specific parts of the brain. These wires send electrical signals that can help stop unwanted muscle movements. Researchers continue to study how well this works for myoclonus.
Getting Ready for Your Medical Visit
Steps You Can Take Beforehand
Preparing ahead helps make the most of a short doctor’s visit.
Start by checking if there are any specific rules or instructions you need to follow before the appointment, such as fasting or bringing records. If unsure, call the office and ask.
Create a list of all your symptoms. Write down when they happen, what seems to make them better or worse, and how severe they are.
Noting these patterns can help your provider understand your situation faster.
Bring a complete list of medications you’re taking. This should include prescription drugs, over-the-counter medicines, vitamins, and supplements. Keeping everything written down in one place saves time and prevents confusion.
Think ahead about what you want to get from the visit. Write out any questions you have for the provider. Consider using a notebook or a note app on your phone. Here are some sample questions:
| Possible Questions to Ask |
|---|
| What could be causing my symptoms? |
| Are there other possible reasons for what I’m experiencing? |
| What tests might I need? |
| Is this condition short-term or long-lasting? |
| What treatments are available, and what do you recommend? |
| Are there other ways to treat this besides your main suggestion? |
| Are there any restrictions I should follow? |
| Where can I learn more about this condition? |
Tip: If you remember a question during the visit, don’t hesitate to speak up. Doctors expect questions and are there to help.
Questions Your Provider May Ask
The doctor will likely want detailed information about your health and symptoms. Being ready can help your visit go smoothly. Some things your doctor might ask include:
- When did your symptoms start?
- Are your symptoms mild, moderate, or severe?
- Do you or your family have a history of conditions such as myoclonus, epilepsy, or seizures?
- Have the symptoms stayed the same, or do they come and go?
- Has anything helped relieve your symptoms?
- Are there certain conditions or activities that make your symptoms worse?
- Have you ever been exposed to certain chemicals or medicines that might play a role?
- Do you have any other health problems that could be linked?
If you know your family history, bring any details that could relate to neurological problems. If you aren’t sure, it’s fine to say so.
If you write down or organize this information before the visit, you can spend less time thinking and more time getting answers. This approach also helps your doctor decide what tests or next steps to take.
