Fasciculations from Epilepsy?

[Nancy703]

I have had complex partial secondary generalized epilepsy for 30 years (since I was 18)  Have been on Dilantin 600 mgs/day.  I have had a kind of neuropathy in my feet progressing over years.
My Neuro took me off Dilantin and tried Tegretol.  Tegretol gave me hyponatremia and bad nausea.  I'm back on Dilantin.  I have had muscle twitches that started in my feet and gradually went up and now are all over my body.  Neuro gave me Klonopin for them because they drive me crazy.  It has helped quite a bit but I still have them.  Are these a part of epilepsy?  My EMG came out negative for ALS.  I also have Cervical Spondylosis (only thing it showed was ridging and compromise of both C5 foramina and mild compromise of C6 foramina).  Sometimes these twitches move my big toes.  Also, what's the diff between myoclonus and fasciculations?  Are they the same thing?

Thank you so much

[CCF-Neuro-M.D.-CS]

If this was not part of your clinical seizures before, then these are most liekly not related to your epilepsy. Myoclonus is a very brief movement of a muscle which is caused by a signal from the brain and sometimes the spinal cord. Fasciculations are spontaneous firing of muscles, sometimes secondary to the nerve or muslce itself. If the cervical stenosis is not causing compression of the cord then it is unlikely to be causing the symptoms. Has any other new medication been started. Also have your electrolytes been checked? Otherwise if the EMG is normal, there is an entity called benign fasciculation syndrome, which involves intermittent twitches, with no progression.

If you are still concerned, then a second opinion with a neuromuscular specialist at an academic hospital would be reasonbale. Good luck