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Treatment of myoclonus

INTRODUCTION

Myoclonus is a clinical sign characterized by sudden, brief, shock-like, involuntary movements caused by muscular contractions or inhibitions. Muscular contractions produce "positive myoclonus," whereas muscular inhibitions produce "negative myoclonus" or asterixis. Myoclonic movements have many possible etiologies, anatomic sources, and pathophysiologic features. Treatment is generally guided by the anatomic and physiologic classification of the myoclonus in question.

This topic will review the treatment of myoclonus. The treatment of myoclonic epilepsy is discussed separately. (See "Epilepsy syndromes in children", section on 'Juvenile myoclonic epilepsy' and "Epilepsy syndromes in children", section on 'Myoclonic epilepsy of infancy' and "Epilepsy syndromes in children", section on 'Absence seizures'.)

Other clinical aspects of myoclonus are reviewed elsewhere. (See "Classification and evaluation of myoclonus" and "Symptomatic (secondary) myoclonus".)

GENERAL APPROACH

The classification of myoclonus is important because it is helpful to guide treatment choices for the many different types of myoclonus. The classification of myoclonus is reviewed here briefly, and is discussed in greater detail separately. (See "Classification and evaluation of myoclonus" and "Symptomatic (secondary) myoclonus".)

The most useful scheme for therapeutic decisions classifies myoclonus by the localization of the physiologic mechanism that generates it (table 1). These anatomic-physiologic categories (along with important examples) are as follows:

                 

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Literature review current through: Oct 2014. | This topic last updated: Jul 24, 2013.
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