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Myclonis, Multiple Sclerosis, Psuedo-Parkinsons, or what?
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Myclonis, Multiple Sclerosis, Psuedo-Parkinsons, or what?


  In April, 1998, I began feeling really run down, had a constant headache,
  and then I got these muscle jerks in my stomach.  The first time this
  happened, I had just lay down to go to bed and I had a few
  mild jerks.  I ignored it.  About three weeks later, I got the jerks
  again.  This time they were more violent and would raise my trunk up
  with each jerk.  At first it only happened when I was laying down, then it
  started happening anytime I would relax, whether laying down or sitting
  up.  After a week or so it started happening when I was standing and my
  right leg would give out on me when I walked.  I noticed the "jerks" were
  worse when I was tired, stressed, or hot.  They never happened when I
  was asleep.  The first neurologist I saw told me I might have Multiple
  Sclerosis.  He did an MRI of my brain and thoracic spinal cord, an EEG,
  auditory and visual tests, and everything came back normal.  He told me
  there was nothing more he could do for me, that he wouldn't know if it
  was MS for 6 months.  Another neurologist teated it as possible anxiety
  and gave me Klonopin which knocked me out and didn't really help the
  jerking.  My family doctor told me I had a demyelinating disease, the next
  week he told me I had Pseudo-Parkinsons (whatever that is).  During this
  whole thing, I had been taking Prozac for PMS.  I asked every physician
  I talked to if that was causing all this.  They said no or probably not.
  I stopped taking the Prozac for a couple of weeks, didn't get better, and
  went back on it.  Stopped taking it again and after a week, stopped
  jerking completely.  After 5 weeks without Prozac, I started jerking
  again, so I went back on the Prozac.  Now my jerking is worse, but it's
  a little different.  It happens mostly when I'm standing or walking and
  doubles me over.  I went back to a different neurologist and she wants
  to treat it as semi-myoclonus (or something like that).  I'm reluctant to
  take Depakote, which she prescribed, because I can't handle being any more
  sleepy.  She also suggested it may be Narcolepsy, but she didn't think so.
  Other symptoms I've had during this time are hesitancy urinating,
  tingling arms, a recurring blister-like sore on my tongue, a rash on my
  forehead, staring eyes, trouble concentrating, loss of thought
  while in mid-sentence, hand twitches, and constant headaches (mostly
  in my temples).  I've been off Prozac now for about three weeks after
  taking it for two weeks.  I went without jerking for two days, but I'm
  back at it again today.  If anyone could give me a little direction on
  what to do about this problem, I would greatly appreciate it.  Thank you.
===========================================================================
Dear Michelle:
The truncal jerking that you describe is quite a rare symptom. One of the things I thought of on reading your description has been called "spinal myoclonus". This disorder occurs in the setting of pathology within the spinal cord, and can potentially occur with multiple sclerosis, viral myelitis, trauma, tumor, and some other spinal cord conditions. If it is indeed that condtion, Klonopin and Depakote may be good drugs for treating it. A normal MRI may nor rule out a spinal cord problem. Another condition that can potentially cause repetitive truncal jerking is a dystonia, which is most commonly drug-induced.
Prozac can potentially cause "parkinsonism" and other extrapyramidal side effects, although this is admittedly less common than with several other psychotropic medications.
It may be a good idea for you to see an expert on movement disorders at a tertiary academic neurology department of repute near you. Dr. R. Stanley Burns and Dr. Erwin Montgomery are such neurologists at the Cleveland Clinic, in case you live near here. You may call (216)444-5559 or (800)223-2273 toll free for an appointment.




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