Myoclonus

[Michael G]

Dear Doctor,
I am a 52 year old, reasonably fit, male with no major illnesses. Recently I consulted a  physician about a breathing problem and he diagnosed it as a ‘myoclonic jerk’ and that I should try to ignore it. Looking at your FAQ on myoclonus though my  symptoms do seem a bit different to those described. The symptom I have occurs irregularly throughout the day or night and is a bit startling. I experience a sudden sharp involuntary intake of breath which leads to either a snorting noise or a single stifled hiccup. I have been assured that there is no serious health threat from this but I wondered if there is any medication available which could help with this problem.    
Thanks for your help
MIKE

[CCF Neuro[P] MD, RPS]

Dear Mike:

Myoclonic jerks can be from a number of reasons.  Is you jerk of one arm, both arms, leg or legs, etc.?  If your jerks are more of a startle jerk and this seems to be increasing, I would just get checked out by a neurologist.  This would be just to rule out the worrisome etiologies.  There are some medications that can help, benzodiazepines, topramax, and lactimal (subpopulation of patients).

Sincerely,

CCF Neuro MD

[FRANKIE]

I don't mean to post under here but have never been able to make a new post. I'm a 28 year old female. I have congenital muscular dystrophy and was wanting to know if it is possible that I could have MS as well. Can someone with CMD also have MS? Over the last year about once a month I experience a burning sensation across the back of my shoulders. My right foot gets hot and tingles. I have twitches in my right foot, right thigh, right thumb, and right upper arm. This occurs every month and used to last just a few hours the first month, then the whole day and now it's lasting 2 days. Does this sound like MS and is it even possible or common to have it on top of CMD? I'm still ambulatory but extremely weak all over my entire body. Every muscle is affected by my CMD except my mouth and internal organs. Appreciate any advise.

[Audrey, Dr., please help]

In 1997, I had a brain hemorrhage (left sided weakness and visual disturbances), crainiotomy to locate AVM and neurosurgery to remove it from my right parietal lobe. Two days after surgery I had status epileptus (don't know how long I stopped breathing). I now take 350/120 mg/day dilantin/phenobarb.  I have not had another grand mal despite my drug serum levels always being below theraputic.  My neurologist says I have epilepsy because I had surgery.  I had one EEG that showed some "glitches" but was negative.  I have two types of "episodes" that I need help identifying.
1)  Feel like I went down a roller coaster, feel derealized but can talk, start trembling (legs won't support me). Lasts a few minutes.  Neuro says it's generalized seizure and dilantin stops grand mal.  Can't find any literature to support theory.
2)  Sudden dimming, visual depth perception problems (stucco on ceiling looks like it's indented), feel like I'm somewhere else, left side face numb, left leg tingles then left arm then left foot off and on for about an hour. No headache (migraine) present or follows. Stops as quickly as starts.  I don't think it's anxiety since no sweating, heartrate/respiration increases.  Neuro says brain damage or seizure.  Lasts too long for seizure?  Do anticonvulsants stop symptoms of brain damage or only control seizures?  Only thing that has helped in the past is increasing phenobarb. Sorry to but in but I'm desperate.

[Audrey, again.]

I forgot to ask how does parietal lobe epilepsy manifest itself and mention hemorrhage covered right frontal lobe also.

[CCF Neuro[P] MD, RPS]

Dear Frankie:

Sorry to hear about your congenital muscular dystrophy.  While anything is possible, it is unlikely that you also have MS.  The symptoms are episodic but seemingly to regular in frequency to be MS.  However, I would just visit with your neurologist to verify that you do not have MS.

Sincerely,

CCF Neuro MD

[Annie O]

My brother, age 45, has been taking pain meds (like vicodin) for a number of years for severe back pain (chronic disc problems.) Recently, he has developed jerks and twitches while sleeping that seem to be myoclonic in nature. On the maternal side of our family, 4 of the 6 children in our mother's nuclear family had seizure disorders. Our mother did not. A cousin, on the maternal side, a male, age 43, had a seizure 1 year ago. His mother also has a seizure disorder.
My brother has seen a neurologist once, and will be following up. Could there be a connection between his pain meds and these jerks/twitches? Should he have an EEG? Any questions he should pose to his neurologist? Thank you.

[CCF Neuro[P] MD, RPS]

Dear Annie O:

One needs to find out if the jerking at night is truely myoclonic epilepsy.  An EEG should be performed.  It might be necessary to do video-EEG if he only myoclonic behavior at night and the initial EEG is normal.  There are some movements that might look like seizures but are just sleeping paroxysms and are normal.  However, the neurologist must be able to define whether these events are seizures or not.

CCF Neuro MD