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Myoclonus
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Myoclonus


  My husband was just told that he has Myoclonus. The neurologist said we don't know what causes it or how to cure it but take the drug clonazepam and the symptoms will go away. Well I think there should be more to this than that.
  First he twitches only in his lower extemities. It can get so bad he can't sleep because  the twitches are so violent he almost jumps off the bed. When he concentrates on it he can make it stop. This problem came up about a month before he had surgery on his rotator cuff(it was very inflamed)could the inflamation (inflammation) have gone into the central nervous system and caused this? Does it get progressively worse after time even with medication or is it just going to stay an inconvenience. I know it get real bad without the meds. He gets cramps in his hands frequently could this be a symptom? Where can I look for more info on this condition and I have noticed there are different myoclonus'does his sound like the regular or one of the others. Thank you for your time. Dee
Dear Dee:
I am sorry to hear that your husband has myoclonus.  Let me describe the usual myoclonic movement and see if it fits with your husband.  Myoclonus encompasses several involunatary movements characterized by rapid muscle jerks.  The are less frequent and severe during sleep but may not disappear.  It may be rhythmic or nonrhythmic, focal, multifocal or generalized; or spontaneous or activated by movement or sensory stimulation.  Another movement is a tic, which may be suppressed by voluntary effort, myoclonus cannot be suppressed.  Chorea is more random than myoclonus and tends to be incorporated into voluntary movements.  Rhythmic myoclonus and tremor look alike and are distinguished with certainity only by special studies.  Tremor is a continuous to-and-fro movement, whereas rhythmic myoclonus has a pause between movements.  Where does your husband fit?  There is also a physiological myoclonus that occurs in NORMAL people when falling asleep, during sleep, when waking up, and during times of anxiety.  Nocturnal myoclonus is a rhythmic jerking of the LEGS during sleep that is common in children.  There is a syndrome named restless legs syndrome, a genetic disorder transmitted by autosomal dominant inheritance.  It is characterized by leg discomfort at rest that is relieved by movement.  Periodic limb movements mainly occur during sleep but also during wakefulness.  Epileptic myoclonus is associated with epileptiform activity on the EEG whereas symptomatic myoclonus is caused by drugs or follows a cerebral injury or is part of a generalized and usually progressive encephalopathy.  Sorry for the long laundry list of things, but myoclonic movements can be different things.  What sort of work-up has your neurologist done thus far?  If the work-up is in progress, hang-in there and wait for the results of the studies.  If your neurologist is not planning a work-up then I would get a second opinion.  Here at the Cleveland Clinic we have several movement disorder specialist and one of the highest rated epilepsy programs in the world.  Best of luck.  Let us know if we can help in any way.
Sincerely,
CCF. Neuro[P] MD, RPS  




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