Hostname: page-component-7c8c6479df-995ml Total loading time: 0 Render date: 2024-03-29T13:37:12.542Z Has data issue: false hasContentIssue false

Myoclonus

Published online by Cambridge University Press:  02 December 2014

Jean Rivest*
Affiliation:
Department of Neurology, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Myoclonus refers to brief muscle jerks caused by neuronal discharges. Etiologies are numerous, ranging from physiological jerks to myoclonus secondary to severe neurodegenerative conditions. The source of myoclonus may be in the cerebral cortex, the brain stem or the spinal cord and multiple generators may be involved in a single patient. The clinical approach to myoclonus relies on both etiological and physiological classifications. Pharmacological therapy is largely based on the presumed site of origin of myoclonus. Polytherapy may be required, particularly in severe cases of cortical myoclonus.

Résumé

RÉSUMÉ

La myoclonie dégne des secousses musculaires brès causé par des déarges neuronales. L’éologie est varié allant de secousses physiologiques àes myoclonies secondaires àes maladies neurodénétrices séres. La source des myoclonies peut provenir du cortex cébral, du tronc cébral ou de la moelle éniè et des sources multiples peuvent coexister chez le mê patient. L’approche clinique est basésur des classifications éologiques et physiologiques. Le traitement pharmacologique est basén grande partie sur le site d’origine prémées myoclonies. Une polythépie peut êe néssaire, particulièment chez les cas séres de myoclonies d’origine corticale.

Type
Research Article
Copyright
Copyright © The Canadian Journal of Neurological 2003

References

1. Marsden, CD, Hallett, M, Fahn, S. The nosology and pathophysiology of myoclonus. In: Marsden, CD, Fahn, S, (Eds). Movement Disorders. Butterworth & Co Publishing 1981: 196248.Google Scholar
2. Ikeda, A, Kakigi, A, Funai, N et al. Cortical tremor: a variant of cortical reflex myoclonus. Neurology, 1990; 40: 15611565.CrossRefGoogle ScholarPubMed
3. Toro, C, Pascual-Leone, A, Deushchl, G, et al. Cortical tremor: a common manifestation of cortical myoclonus. Neurology 1993, 43: 23462353.Google Scholar
4. Obeso, J. Classification, clinical features, and treatment of myoclonus. In: Watts, RL, Koller, WC, (Eds). Movement Disorders: Neurologic Principles and Practice. Mcgraw-Hill 1997:541550.Google Scholar
5. Quinn, N. Essential myoclonus and myoclonic dystonia. A review. Mov Disord 1996;11:119124.CrossRefGoogle ScholarPubMed
6. Hallett, M. Myoclonus: relations to epilepsy. Epilepsia 1985;26 (Suppl 1):S67-S77.CrossRefGoogle ScholarPubMed
7. Marsden, CD. Myoclonus: Classification, Pathophysiology and Treatment. American Academy of Neurology Course on Movement Disorders 1992:93122.Google Scholar
8. Lance, JW, Adams, RD. The syndrome of intention or action myoclonus as a sequel of hypoxic encephalopathy. Brain 1963;86:111136.Google Scholar
9. Berkovic, SF, Andermann, F, Carpenter, S, Wolfe, LS. Progressive myoclonus epilepsies: specific causes and diagnosis. N Engl J Med 1986;315: 296305.Google Scholar
10. Hauser, WA, Morris, M, Heston, LL, Anderson, VE. Seizures and myoclonus in patients with Alzheimer’s disease. Neurology 1986;36:12261230.CrossRefGoogle ScholarPubMed
11. Thompson, PD, Day, BL, Rothwell, JC, et al. The myoclonus in corticobasal degeneration. Evidence for two forms of cortical reflex myoclonus. Brain 1994;117:11971207.Google ScholarPubMed
12. Obeso, JA, Zubieta, JL, Artieda, J, Rodriguez, ME. Reflex myoclonus in olivo-ponto-cerebellar atrophy. J Neurol Neurosurg Psychiatry 1994; 57: 316319.Google Scholar
13. Chen, R, Ashby, P, Lang, AE. Stimulus-sensitive myoclonus in akinetic-rigid syndromes. Brain 1992; 115: 18751888.Google Scholar
14. Thompson, PD, Bhatia, KP, Brown, P, et al. Cortical myoclonus in Huntington’s disease. Mov Disord 1994; 9: 633641.Google Scholar
15. Anderson, NE, Budde-Steffen, C, Rosenblum, MK, et al. Opsoclonus, myoclonus, ataxia and encephalopathy in adults with cancer: a distinct paraneoplastic syndrome. Medicine 1988;67(2):100109.Google Scholar
16. Schwartz, NA, Selhorst, JB, Ochs, AL, et al. Oculomasticatory myorythmia: a unique movement disorder occurring in Whipple’s disease. Ann Neurol 1986;20: 677683.Google Scholar
17. Obeso, JA, Rothwell, JC, Marsden, CD. The spectrum of cortical myoclonus. From focal reflex jerks to spontaneous motor epilepsy. Brain 1985;108:193224.CrossRefGoogle ScholarPubMed
18. Obeso, JA, Artieda, J, Rothwell, JC, Thompson, P, Marsden, CD. The treatment of severe action myoclonus. Brain 1989;112: 765777.CrossRefGoogle ScholarPubMed
19. Brown, P, Day, BL, Rothwell, JC, Thompson, PD, Marsden, CD. Intrahemispheric and interhemispheric spread of cerebral cortical myoclonic activity and its relevance to epilepsy. Brain 1991;114:23332351.Google Scholar
20. Hallett, M, Chadwick, D, Adam, J, Marsden, CD. Reticular reflex myoclonus: a physiological type of human posthypoxic myoclonus. J Neurol Neurosurg Psychiatry 1977;40:253264.CrossRefGoogle Scholar
21. Lapresle, J. Palatal myoclonus. Adv Neurol 1986;43:265274.Google ScholarPubMed
22. Dubinsky, RM, Hallett, M, Di Chiro, G, et al. Increased glucose metabolism in the medulla of patients with palatal myoclonus. Neurology, 1991 ; 41: 557562.Google Scholar
23. Deuschl, G, Toro, C, Valls-Solé, J, et al. Symptomatic and essential palatal tremor. Brain 1994;117:775788.Google Scholar
24. Hoehn, M, Cherington, M. Spinal myoclonus. Neurology 1977;27: 942946.CrossRefGoogle ScholarPubMed
25. Jankovic, J, Pardo, R. Segmental myoclonus: clinical and pharmacological study. Arch Neurol 1986;43: 10251031.Google Scholar
26. Fox, EJ, Villaneva, R, Schutta, H. Myoclonus following spinal anesthesia. Neurology 1979;29: 379380.Google Scholar
27. Brown, P, Thompson, PD, Rothwell, JC, Day, BL, Marsden, CD. Axial myoclonus of propriospinal origin. Brain 1991;114: 197214.Google Scholar
28. Brown, P. Spinal Myoclonus. In: Marsden, CD, Fahn, S, (Eds). Movement Disorders 3. Butterworth-Heineman Ltd, 1994:459476.Google Scholar
29. Chadwick, D, Hallett, M, Jenner, P, Marsden, CD. Treatment of post-hypoxic action myoclonus. Implications for the pathophysiology of the disorder. Adv Neurol 1986;43:183190.Google Scholar
30. Van Woert, MH, Rosenbaum, D, Chung, E. Biochemistry and therapeutics of posthypoxic myoclonus. Adv Neurol 1986;43: 171181.Google Scholar
31. Prince, D. Physiological mechanisms of focal epileptogenesis. Epilepsia 1985; 26(Suppl 1) S3-S14.Google Scholar
32. Chokroverty, S, Manocha, M, Duvoisin, R. A physiologic and pharmacologic study in anticholinergic-responsive essential myoclonus. Neurology 1987;37:608615.Google Scholar
33. Obeso, JA, Artieda, J, Tunon, T, et al. Dopamine agonists suppress visual-cortical reflex myoclonus. J Neurol Neurosurg Psychiatry 1985;48:12771283.Google Scholar
34. Van Woert, MH, Chung, E. Possible mechanisms of action of valproic acid in myoclonus. Adv Neurol 1986;43: 653659.Google Scholar
35. Jenner, P, Pratt, JA, Marsden, CD. Mechanism of action of clonazepam in myoclonus in relation to effects on GABAand 5-HT. Adv Neurol 1986;43: 629643.Google Scholar