Myoclonus [Neurosurgery Wiki]

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====== Myoclonus ======

Myoclonus ([[tonic]]-[[clonic]] [[muscle spasm]]s) (can be epileptic or non-epileptic)

Myoclonus refers to a quick, involuntary muscle jerk. Hiccups are a form of myoclonus, as are the sudden jerks, or "sleep starts," you may feel just before falling asleep. These forms of myoclonus occur in healthy people and rarely present a problem.

May be present in [[hypoxic coma]].

[[Asterixis]], [[tremor]], myoclonus may be present in [[metabolic coma]].

Myoclonus is usually more prominent early in toxic/metabolic disorders than in [[CJD]], and [[seizure]]s in CJD are usually late
((Johnson RT, Gibbs CJ. Creutzfeldt-Jakob Disease and Related Transmissible Spongiform Encephalopathies. N Engl J Med. 1998; 339:1994– 2004)).
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In [[Tuberous sclerosis complex]], [[infantile myoclonus]] may also occur.
In older children or adults, the myoclonus is often replaced by generalized tonic-clonic or partial complex seizures, which occur in 70–80%. Facial adenomas are not present at birth but appear in > 90% by age 4 yrs (these are not really adenomas of the sebaceous glands, but are small hamartomas of cutaneous nerve elements that are yellowish-brown and glistening and tend to arise in a butterfly malar distribution, usually sparing the upper lip).
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see [[Myoclonus dystonia syndrome]]. 

===== Treatment =====
[[Perampanel]] with [[baclofen]] may be effective for [[myoclonus]] due to respiratory reflex disinhibition and can be used to treat [[hiccups]] derived from [[cerebral infarction]]s
((Morita K, Nuki Y, Hashizume H, Togo M. Persistent [[Hiccups]] Induced by [[Supratentorial]] [[Infarct]]s and Successful Treatments With Combination of [[Perampanel]] and [[Baclofen]]: A Case Report. Clin Neuropharmacol. 2022 Aug 4. doi: 10.1097/WNF.0000000000000514. Epub ahead of print. PMID: 35947416.)).