Myoclonus: What you need to know

Myoclonus seizures are short, electric shock-like seizures of a muscle or group of muscles. Usually a muscle twitch doesn't last more than a second or two. There may be only one attack, but sometimes multiple attacks occur over a short period of time.
In epilepsy, muscle twitches often cause abnormal movements on both sides of the body at the same time. Myoclonu s can occur in many epilepsy syndromes with different features:
Juvenile myoclonic seizures: Myoclonic seizures often involve the neck, shoulders, and upper arms. In many patients, myoclonic seizures occur immediately upon awakening. The disease usually begins around puberty or sometimes in early adulthood. In most cases, these myoclonic seizures can be well controlled with medication, but lifelong treatment is required. Lennox-Gastaut Syndrome: This is a rare syndrome that begins in childhood. This syndrome is a combination of many types of epilepsy such as generalized tonic-clonic seizures, myasthenic seizures, absence seizures... Strong muscle tremors in the neck, shoulders, and biceps in both side of the body, this form is difficult to treat. Progressive myoclonic epilepsy: this is a rare condition with a combination of myoclonic epilepsy and generalized tonic-clonic seizures. Treatment is often difficult to succeed and worsens over time. Nonprogressive myoclonic epilepsy: The disease usually begins in infancy and improves with adulthood, but often leaves neuropsychiatric disturbances. Symptoms of the disease are slight muscle twitching in one eyelid, face, arm, and leg accompanied by an absence of consciousness.

Causes of myoclonic seizures include:
Damage or degeneration of the basal ganglia Dementia Metabolic disorders Physical damage to the brain (cortical, subcortical, reticular system, nerve damage) nerves, nerve roots, or peripheral plexus) and hypoxic encephalopathy Toxic encephalopathy Viral encephalitis Drugs MORE: Can epilepsy be diagnosed with a cranial MRI?

Diagnosis of myoclonic epilepsy is based on repeated brief myoclonic seizures with or without loss of consciousness and a number of tests are performed to diagnose epilepsy.

Brain magnetic resonance imaging (MRI) or brain computed tomography (CT-Scan) can identify the anatomical abnormalities that are characteristic of epilepsy syndromes. In addition, injuries from trauma, tumors, infections, and strokes that can cause seizures can be identified and treated accordingly.

EEG checks brain electrical waves to detect muscle twitching activity in the brain. Myoclonus is considered a seizure when it is accompanied by changes in the EEG. Waking EEG is particularly useful for diagnosing muscle seizures that occur shortly before or after sleep.

Juvenile myoclonic epilepsy and some progressive epileptic syndromes characterized by myoclonus are associated with genetic mutations. Because epileptic syndromes respond to specific medications and treatment strategies, genetic testing can help with treatment planning and prognosis.
The differential diagnoses of myoclonic epilepsy include myoclonus , movement disorders , neuromuscular disease or other neurological conditions such as multiple sclerosis .

There are several treatment options for myoclonic epilepsy, but they are generally quite complex. Ideally, an antiepileptic drug should be taken in an acceptable dose to limit side effects, but sometimes multiple anticonvulsants are required to reduce myoclonic seizures. The most commonly used anticonvulsants to prevent myoclonic seizures include: Depakine (valproic acid), Levetiracetam, Topamax (topiramate), Zonisamide.
Myoclonus muscle twitches are usually short-lived and rarely progress to status epilepticus..
Some other treatments include a ketogenic diet (high in fat, enough protein, low in protein). carbohydrates), epilepsy surgery, and anticonvulsant devices such as vagus nerve stimulators. Often, for difficult-to-treat epilepsy, a combination of multiple treatment strategies is required.
In short, myoclonic epilepsy refers to sudden and uncontrolled jerking of a muscle or muscle group. This form of epilepsy causes repeated seizures, altered perception, sensation, limited range of motion, and dysfunction of many organs in the body. Treatment of myoclonic epilepsy is mainly to correct the underlying metabolic disorder, avoid myoclonic initiating drugs, and use antiepileptic drugs.
Vinmec International General Hospital is one of the hospitals with the function of examination, treatment, screening and diagnosis of many diseases, including epilepsy. Especially in order to bring high efficiency in disease examination and treatment, Vinmec is now fully equipped with imaging diagnostic tools to identify diseases and classify epilepsy stages such as: Endoscopy, CT scan , PET-CT scan, MRI, EEG,... Once the disease stage is determined, doctors will advise and give an effective treatment plan.

References: msdmanuals.com, verywellhealth.com