Clinical Utility of Neurophysiologic Classification (and Declassification) of Myoclonus

Abstract

BackgroundMovement clinical neurophysiology studies can distinguish myoclonus, tremor, and other jerky movements; however, there has been limited demonstration of their real‐world clinical impact.ObjectiveThe aim was to investigate movement study utility in clarifying movement classification and guiding patient management.MethodA retrospective study of myoclonus‐related movement studies was performed.ResultsOf 262 patients referred for consideration of myoclonus, 105 (40%) had myoclonus, 156 (59%) had no myoclonus (the commonest alternative classifications were functional jerks and tremor), and 1 was uncertain. An additional 29 studies identified myoclonus without prior clinical suspicion. A total of 119 of 134 (89%) myoclonus patients had a specific neurophysiologic subtype identified, most commonly cortical (64, 54%). Diagnostic differential narrowed in 60% of patients, and a new diagnosis was made in 42 (14%) patients. Medication changes were made in 151 patients (52%), with improvement in 35 of 51 (67%) with follow‐up.ConclusionsMovement studies effectively determined movement classification and identified unsuspected myoclonus, leading to changes in diagnosis and management. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.