Multiple Sclerosis and Myoclonus

Posted By  CCF neuro MD/MRR on March 12, 1998 at 08:25:42:

In Reply to: Multiple Sclerosis and Myoclonus posted by Priscilla on March 06, 1998 at 13:42:59:

: Dear Drs.
  I was diagnosed with MS about a year ago.  I was extremely dizzy and lost some hearing
  in one ear.  I had had double vision 5 years before that.  After the double vision had
  gone away I seemed fine other than tingling sensations from time to time (they
  thought at the time I had had some small strokes.)
  But, this time they diagnosed with RR MS - My dizziness
  has never completely gone away and it's worse some days than others.  Also,
  I have Lhermites syndrome starting with the neck but then I get goose bump feelings
  through my scalp and then numbness sensation in my forehead and face.  This is
  happening more and more often.  Also, I have been diagnosed with noturnal myoclonus.
  It has gotten progressively worse this past year.  I started off taking 5 mg of
  clonozapam, which worked for about 2 months.  Then I started twitching again.
  So, the doctor upped the dosage to 10mgs.  Oh, and of course I'm constantly
  fatigued and on amantadene.  My questions are these - am I in remission?  What
  is the prognosis of the myclonus, is it apt to turn into a daytime thing as
  well?  By evening my legs are very tired and going upstairs they feel very heavy.
  Does this have something to do with the myclonus,
  or the MS?  Right now my legs okay most of the day other than little twitches in my calves.
  My arms are getting weaker too - I don't understand that.  I feel
  kind of like I'm slowly deteriorating - but nothing severe enough to jump up
  and go see the doctor.  Is this all normal with MS?  I have heard that MS
  causes muscle weakness - I can understand the other symptoms, but why muscle
  weakness? - If you can't answer all my questions - the one I'm mainly concerned
  about it the myoclonus thing - why it's happening and what the outlook is
  for it in MS patients.
  By the way I'm a 47 year old female- first episode at 40 - diagnosed at 46.
  Sorry to ramble just wanted to make sure you got all the information you
  might need to answer my questions.
  Thank you in advance for any answers you can give me.
  Priscilla  

[CCF neuro MD/MRR]

Dear Priscilla,
Hello, Well to start to answer your first question- the myoclonus- it happens in people with and without MS at night, it generally does not go on to
occur during the day.  It can be treated with Clonazepam like you have been on and other medications like Valium .etc.
The weakness of your arms and legs is common in MS and is a sign that you should go see a Neurologist
soon so that you can get on a therapy to help deccrease the cahnces of your MS worsening.  The goal
of MS therapy today is being aggresssive early as nerve damage occurrs much earlier than expected in the past.  The new medications help to decrease the chances of
new symptoms and brain lesions so that the threat of nerve damage is less.  The myoclous at night can also be secondary to MS as the muscles get weak they can then have spasms that can be treated with Baclofen or Zanaflex.  
These kind of spasms do occur during the day.  I would encourage you to finda Neuroloigst that is familiar with treating MS , we have a MS center here athe Cleveland Clinic , the number is 216-444-8600 for appointmants.  Godd Luck!