myoclonic seizures

My 22 year old daughter has involuntary contractions of her abdominal and leg muscles that can be violent, causing her to thrash about. Occurs 1-3 times per day.  Lasts 5-30 minutes. She is awake and alert during them.  Usually occur in the evening, but can occur at any time.  She is 2.5 years post Chiari I surgery.  Since that surgery she has had a shunt placed due to high intracranial pressure and has had two cranioplasties and repair of pseudomeningocoele (bulging of the artificial dural patch).  The seizures began a year after her first cranioplasty.  Surgeons thought they might resolve after shunt placement and repair of meningocoele, but they have not, several months later.  Neurologist thought they might be due to zoloft, but she has been off it for three weeks with no improvement.  Other meds are trazadone, ambien and oxycodone (which she is weaning off), florinef, atenolol. Hospital-based EEG was normal, even during the seizures.  Where do we go from here?  What could be causing her problem?  This is taking a severe emotional toll. Thank you!

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

If the event occurred during an EEG recording and absolutely no changes were seen on the EEG, then there is a strong possibility that these are not actually seizures. During a seizure, the brainwave recording shows typical changes consistent with abnormal electrical activity. But if everything remains normal, then the problem is possibly not coming from the brain. If there is any doubt, an admission to an epilepsy monitoring unit to record her activity (both brain wave and video monitoring) may be helpful. It could represent a physical reaction to headache, pain, or something related to her chiari. Another possiblity is a nonepileptic seizure, or what's commonly known as a pseudo seizure which arises from multiple psychosocial issues.  Please keep in mind I have not personally examined your daughter nor have I reviewed her medical history in detail. These are simply suggestions. COnsider getting a second opinion from another neurologist and think about an epilepsy monitoring unit. GOod luck

[E Baker]

There is a very interesting article located at this site:  http:////www.wemove.org/

It mentions that myoclonus doesnt always originate in the brain, but can start in the brain stem or spine.

Good Luck finding answers.

E Baker