Myoclonus - a repeated convulsive twitching major muscle groups. The condition can occur in normal falling asleep,
. If the cause of the disease is the loss of the cerebral cortex, it is customary to speak of cortical myoclonus (myoclonus)
. This disease is a type of hyperkinesis
. Cortical myoclonus is characterized by extreme rapidity seizures
. Patients describe a sudden muscle contraction as a "shock"
. A number of reasons contribute to the development of pathologic myoclonus
. Acquired myoclonic seizures can occur at any age
. In adults they are often found in the background of metabolic disorders
. For example, myoclonus fixed in uremia, ketoacidosis, hyperosmolar coma, lactic acidosis, hypoxia
. In these conditions, the cerebral cortex is damaged by toxic concentrations of metabolic products (nitrogen bases, ketone bodies)
. Newborn myoclonic seizures are fairly common and are associated with neurodegenerative disease (Alpers disease, Tay-Sachs disease)
. Myoclonus may occur as a variant of primary generalized epilepsy and become a manifestation of juvenile myoclonic epilepsy with myoclonic absences or component
. Also, large groups of muscles twitching possible with the progression of various neurological diseases
. More often than cortical myoclonus observed in diffuse brain damage, especially in the involvement of the gray matter
. These lesions of the cerebral cortex are in diseases of accumulation (hemochromatosis, amyloidosis, leukodystrophy and others) and infectious processes (Kozhevnikov epilepsy on the background like progressive forms and other tick-borne encephalitis)
The differential diagnosis of myoclonus
The differential diagnosis of cortical myoclonus needs tremor, tic, tetany, focal motor seizures.
Symptoms of the disease
Symptoms include short myoclonus involuntary contractions of muscles suddenly arise in various parts of the body. By the degree of involvement in the different muscle groups can be generalized myoclonus, regional and local. Localized myoclonus often manifests itself in the rapid reduction of facial muscles, tongue, soft palate. There may be a violation of speech (articulation). Generalised seizures involve spasm in multiple muscle groups. When metabolic disorders (uremia, hypoxia) in the process involves more than just muscles. Most often, there are involuntary contractions in the muscles of the torso, hips, shoulders and face. Sometimes the cramp seizes diaphragm. Like all hyperkinesis, myoclonus enhanced
when emotional experiences. In the dream, symptoms often absent.
Diagnosis is based on observation of myoclonus doctor transient muscle twitching or description of such patient. To clarify the diagnosis is carried out electroencephalography. To identify the cause of seizures is necessary to make a blood test - to determine the level of creatinine and blood urea, blood sugar and some other indicators. Also shown are the imaging techniques - x-ray of the skull, computer or magnetic resonance imaging of the brain. Examination of this disease should spend a neurologist. In some cases, you may need hospitalization in a neurological hospital for further diagnosis.
Treatment of myoclonus
Myoclonus Treatment depends on the cause of the disease. If myoclonus is associated with metabolic disorders, the correction of the primary disease leads to a clear improvement in the neurological picture. Thus in uremia (elevated level of blood creatinine and urea) showed the active treatment of renal failure, including peritoneal dialysis, hemodialysis, renal transplantation. In primary generalized epilepsy with myoclonic seizures the most effective drug is sodium valproate. The therapeutic effect in all forms of the disease have a different anticonvulsants - topiramate, lamotrigine, levetiracetam and zonisamide. For fast effect, you can use benzodiazepines.
Prognosis depends on the etiology of myoclonus. The worst prognosis of generalized myoclonus in the background of a neurodegenerative disease.