Myoclonus
Myoclonus (tonic-clonic muscle spasms) (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 seizures in CJD are usually late 1).
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).
Treatment
Perampanel with baclofen may be effective for myoclonus due to respiratory reflex disinhibition and can be used to treat hiccups derived from cerebral infarctions 2).