Myoclonus

John Nathaniel Caviness, Daniel D. Truong

Research output: Book/ReportBook

19 Citations (Scopus)

Abstract

Myoclonus can be classified as physiologic, essential, epileptic, and symptomatic. Animal models of myoclonus include DDT and posthypoxic myoclonus in the rat. 5-Hydrotryptophan, clonazepam, and valproic acid suppress myoclonus induced by posthypoxia.The diagnostic evaluation of myoclonus is complex and involves an extensive work-up including basic electrolytes, glucose, renal and hepatic function tests, paraneoplastic antibodies, drug and toxicology screens, thyroid antibody and function studies, neurophysiology testing, imaging, and tests for malabsorption disorders, assays for enzyme deficiencys, tissue biopsy, copper studies, alpha-fetoprotein, cytogenetic analysis, radiosensitivity DNA synthesis, genetic testing for inherited disorders, and mitochondrial function studies.Treatment of myoclonus is targeted to the underlying disorder. If myoclonus physiology cannot be demonstrated, treatment should be aimed at the common pattern of symptoms. If the diagnosis is not known, treatment could be directed empirically at cortical myoclonus as the most common physiology. In cortical myoclonus, the most effective drugs are sodium valproic acid, clonazepam, levetiracetam, and piracetam. For cortical-subcortical myoclonus, valproic acid is the drug of choice. Here, lamotrigine can be used either alone or in combination with valproic acid. Ethosuximide, levetiracetam, or zonisamide can also be used as adjunct therapy with valproic acid. A ketogenic diet can be considered if everything else fails. Subcortical-nonsegmental myoclonus may respond to clonazepam and deep-brain stimulation. Rituximab, adrenocorticotropic hormone, high-dose dexamethasone pulse, or plasmapheresis have been reported to improve opsoclonus myoclonus syndrome. Reticular reflex myoclonus can be treated with clonazepam, diazepam and 5-hydrotryptophan. For palatal myoclonus, a variety of drugs have been used.

Original languageEnglish (US)
PublisherUnknown Publisher
Number of pages22
Volume100
DOIs
StatePublished - 2011

Publication series

NameHandbook of Clinical Neurology
Volume100
ISSN (Print)00729752

Fingerprint

Myoclonus
Valproic Acid
Clonazepam
etiracetam
zonisamide
Pharmaceutical Preparations
Opsoclonus-Myoclonus Syndrome
Ethosuximide
Ketogenic Diet
Piracetam
Mitochondrial Diseases
Neurophysiology
Deep Brain Stimulation
DDT
Plasmapheresis
Antibodies
Cytogenetic Analysis
Radiation Tolerance
alpha-Fetoproteins
Enzyme Assays

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Caviness, J. N., & Truong, D. D. (2011). Myoclonus. (Handbook of Clinical Neurology; Vol. 100). Unknown Publisher. https://doi.org/10.1016/B978-0-444-52014-2.00031-8

Myoclonus. / Caviness, John Nathaniel; Truong, Daniel D.

Unknown Publisher, 2011. 22 p. (Handbook of Clinical Neurology; Vol. 100).

Research output: Book/ReportBook

Caviness, JN & Truong, DD 2011, Myoclonus. Handbook of Clinical Neurology, vol. 100, vol. 100, Unknown Publisher. https://doi.org/10.1016/B978-0-444-52014-2.00031-8
Caviness JN, Truong DD. Myoclonus. Unknown Publisher, 2011. 22 p. (Handbook of Clinical Neurology). https://doi.org/10.1016/B978-0-444-52014-2.00031-8
Caviness, John Nathaniel ; Truong, Daniel D. / Myoclonus. Unknown Publisher, 2011. 22 p. (Handbook of Clinical Neurology).
@book{f03484b15b384bdcbfa521b881b55ce3,
title = "Myoclonus",
abstract = "Myoclonus can be classified as physiologic, essential, epileptic, and symptomatic. Animal models of myoclonus include DDT and posthypoxic myoclonus in the rat. 5-Hydrotryptophan, clonazepam, and valproic acid suppress myoclonus induced by posthypoxia.The diagnostic evaluation of myoclonus is complex and involves an extensive work-up including basic electrolytes, glucose, renal and hepatic function tests, paraneoplastic antibodies, drug and toxicology screens, thyroid antibody and function studies, neurophysiology testing, imaging, and tests for malabsorption disorders, assays for enzyme deficiencys, tissue biopsy, copper studies, alpha-fetoprotein, cytogenetic analysis, radiosensitivity DNA synthesis, genetic testing for inherited disorders, and mitochondrial function studies.Treatment of myoclonus is targeted to the underlying disorder. If myoclonus physiology cannot be demonstrated, treatment should be aimed at the common pattern of symptoms. If the diagnosis is not known, treatment could be directed empirically at cortical myoclonus as the most common physiology. In cortical myoclonus, the most effective drugs are sodium valproic acid, clonazepam, levetiracetam, and piracetam. For cortical-subcortical myoclonus, valproic acid is the drug of choice. Here, lamotrigine can be used either alone or in combination with valproic acid. Ethosuximide, levetiracetam, or zonisamide can also be used as adjunct therapy with valproic acid. A ketogenic diet can be considered if everything else fails. Subcortical-nonsegmental myoclonus may respond to clonazepam and deep-brain stimulation. Rituximab, adrenocorticotropic hormone, high-dose dexamethasone pulse, or plasmapheresis have been reported to improve opsoclonus myoclonus syndrome. Reticular reflex myoclonus can be treated with clonazepam, diazepam and 5-hydrotryptophan. For palatal myoclonus, a variety of drugs have been used.",
author = "Caviness, {John Nathaniel} and Truong, {Daniel D.}",
year = "2011",
doi = "10.1016/B978-0-444-52014-2.00031-8",
language = "English (US)",
volume = "100",
series = "Handbook of Clinical Neurology",
publisher = "Unknown Publisher",

}

TY - BOOK

T1 - Myoclonus

AU - Caviness, John Nathaniel

AU - Truong, Daniel D.

PY - 2011

Y1 - 2011

N2 - Myoclonus can be classified as physiologic, essential, epileptic, and symptomatic. Animal models of myoclonus include DDT and posthypoxic myoclonus in the rat. 5-Hydrotryptophan, clonazepam, and valproic acid suppress myoclonus induced by posthypoxia.The diagnostic evaluation of myoclonus is complex and involves an extensive work-up including basic electrolytes, glucose, renal and hepatic function tests, paraneoplastic antibodies, drug and toxicology screens, thyroid antibody and function studies, neurophysiology testing, imaging, and tests for malabsorption disorders, assays for enzyme deficiencys, tissue biopsy, copper studies, alpha-fetoprotein, cytogenetic analysis, radiosensitivity DNA synthesis, genetic testing for inherited disorders, and mitochondrial function studies.Treatment of myoclonus is targeted to the underlying disorder. If myoclonus physiology cannot be demonstrated, treatment should be aimed at the common pattern of symptoms. If the diagnosis is not known, treatment could be directed empirically at cortical myoclonus as the most common physiology. In cortical myoclonus, the most effective drugs are sodium valproic acid, clonazepam, levetiracetam, and piracetam. For cortical-subcortical myoclonus, valproic acid is the drug of choice. Here, lamotrigine can be used either alone or in combination with valproic acid. Ethosuximide, levetiracetam, or zonisamide can also be used as adjunct therapy with valproic acid. A ketogenic diet can be considered if everything else fails. Subcortical-nonsegmental myoclonus may respond to clonazepam and deep-brain stimulation. Rituximab, adrenocorticotropic hormone, high-dose dexamethasone pulse, or plasmapheresis have been reported to improve opsoclonus myoclonus syndrome. Reticular reflex myoclonus can be treated with clonazepam, diazepam and 5-hydrotryptophan. For palatal myoclonus, a variety of drugs have been used.

AB - Myoclonus can be classified as physiologic, essential, epileptic, and symptomatic. Animal models of myoclonus include DDT and posthypoxic myoclonus in the rat. 5-Hydrotryptophan, clonazepam, and valproic acid suppress myoclonus induced by posthypoxia.The diagnostic evaluation of myoclonus is complex and involves an extensive work-up including basic electrolytes, glucose, renal and hepatic function tests, paraneoplastic antibodies, drug and toxicology screens, thyroid antibody and function studies, neurophysiology testing, imaging, and tests for malabsorption disorders, assays for enzyme deficiencys, tissue biopsy, copper studies, alpha-fetoprotein, cytogenetic analysis, radiosensitivity DNA synthesis, genetic testing for inherited disorders, and mitochondrial function studies.Treatment of myoclonus is targeted to the underlying disorder. If myoclonus physiology cannot be demonstrated, treatment should be aimed at the common pattern of symptoms. If the diagnosis is not known, treatment could be directed empirically at cortical myoclonus as the most common physiology. In cortical myoclonus, the most effective drugs are sodium valproic acid, clonazepam, levetiracetam, and piracetam. For cortical-subcortical myoclonus, valproic acid is the drug of choice. Here, lamotrigine can be used either alone or in combination with valproic acid. Ethosuximide, levetiracetam, or zonisamide can also be used as adjunct therapy with valproic acid. A ketogenic diet can be considered if everything else fails. Subcortical-nonsegmental myoclonus may respond to clonazepam and deep-brain stimulation. Rituximab, adrenocorticotropic hormone, high-dose dexamethasone pulse, or plasmapheresis have been reported to improve opsoclonus myoclonus syndrome. Reticular reflex myoclonus can be treated with clonazepam, diazepam and 5-hydrotryptophan. For palatal myoclonus, a variety of drugs have been used.

UR - http://www.scopus.com/inward/record.url?scp=79954550904&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79954550904&partnerID=8YFLogxK

U2 - 10.1016/B978-0-444-52014-2.00031-8

DO - 10.1016/B978-0-444-52014-2.00031-8

M3 - Book

C2 - 21496598

AN - SCOPUS:79954550904

VL - 100

T3 - Handbook of Clinical Neurology

BT - Myoclonus

PB - Unknown Publisher

ER -