Segmental Myoclonus

Caviness, John N.

doi:10.1002/9781444346183.ch15

Cited by 11 publications

(10 citation statements)

References 97 publications

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“…It produces rhythmic muscle jerks at a typical frequency of 1–3 Hz, that are frequently associated with pain and demonstrate no particular association to stimulus intensity6 or EEG changes 7. On the contrary, PSM, a rare manifestation of the disorder, describes complex, multisegmental simultaneous myotomal involvement of the trunk and limbs, mediated through intersegmental fibre tracts,8 while sparing cranially innervated and bulbar muscles 3 9–11. These are usually arrhythmic with direct correlation to stimulus sensitivity.…”

Section: Discussionmentioning

confidence: 99%

“…With the majority of spinal myoclonus being idiopathic in origin, various other pathologies have been implicated as potential causes, including infective/inflammatory,15–17 postinfective,18 intramedullary or extramedullary neoplasms,19 paraneoplastic,20 syringomyelia,10 21 spinal cord trauma,22 23 vascular abnormalities, degenerative motor neuron disease and demyelination24 and cervical spondylosis 21 25. Thus, a contrast-enhanced MRI of the whole neuro-axis is essential to identify the segmental lesion responsible for the myoclonus which should be later supplemented with additional investigations to exclude a systemic disorder (eg, vitamin B 12 deficiency and HIV) 8. Several reports have also linked spinal myoclonus with postoperative changes associated with laminectomies26 but no clear correlation has been demonstrated between degenerative spinal disease and movement disorders, that included myoclonus,7 21 27dystonia28–30 and choreoathetosis 31.…”

Section: Discussionmentioning

confidence: 99%

“…Following the above-suggested mechanisms, the overall aim in treatment rests to re-establish the equilibrium between inhibitory and excitatory neuronal activity 8. This is generally achieved through antiseizure medication that dampens the hyperexcitable state of the ventral horn neurons by stimulating the remaining, functioning inhibitory interneurons.…”

Section: Discussionmentioning

confidence: 99%

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Spinal myoclonus: a rare presentation of cervical myelopathy

Christodoulides¹,

Giamouriadis

Bashford

et al. 2018

BMJ Case Reports

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Myoclonus describes a movement disorder characterised by brief, abrupt and involuntary contractions of muscles or groups of muscles, usually associated with intracranial lesions, with limited evidence linking it to spinal pathologies. The pathophysiology of spinal myoclonus is extensive and multifactorial. Infection, intramedullary and extramedullary space-occupying lesions, trauma, vascular abnormalities, degenerative processes and cervical spondylosis have been implicated with the disease, the latter been associated with cervical stenosis with no reported cases linking it to an underlying cervical disc herniation. Although medical therapy with clonazepam, levetiracetam, valproate, tetrabenazine hydrochloride and spinal block injections has been equivocal, spinal myoclonus secondary to disc herniation requires surgical intervention. This report describes a case of segmental spinal myoclonus, secondary to a herniated cervical intervertebral disc. After corpectomy and a cage-augmented fusion technique, the myoclonic symptoms resolved. To our knowledge, this was the first report to describe the successful management of discogenic spinal myoclonus with spinal surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Spinal myoclonus: a rare presentation of cervical myelopathy

Christodoulides¹,

Giamouriadis

Bashford

et al. 2018

BMJ Case Reports

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“…These oscillations are transmitted to anterior horn cell neurons in corresponding myotomes leading to their spontaneous bursting. [ 55 56 ] EMG discharge duration varies between 50 and 1000 ms and is not accompanied by any electrophysiological cortical correlate. It is usually secondary to underlying structural spinal cord pathologies such as myelitis, syringomyelia, spinal cord trauma, vascular lesions, or malignancy.…”

Section: N Europhysiological C Lassificationmentioning

confidence: 99%

Myoclonus- A Review

Chandarana

Saraf

Kajaria

et al. 2021

Annals of Indian Academy of Neurology

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Myoclonus is a hyperkinetic movement disorder characterized by a sudden, brief, involuntary jerk. Positive myoclonus is caused by abrupt muscle contractions, while negative myoclonus by sudden cessation of ongoing muscular contractions. Myoclonus can be classified in various ways according to body distribution, relation to activity, neurophysiology, and etiology. The neurophysiological classification of myoclonus by means of electrophysiological tests is helpful in guiding the best therapeutic strategy. Given the diverse etiologies of myoclonus, a thorough history and detailed physical examination are key to the evaluation of myoclonus. These along with basic laboratory testing and neurophysiological studies help in narrowing down the clinical possibilities. Though symptomatic treatment is required in the majority of cases, treatment of the underlying etiology should be the primary aim whenever possible. Symptomatic treatment is often not satisfactory, and a combination of different drugs is often required to control the myoclonus. This review addresses the etiology, classification, clinical approach, and management of myoclonus.

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“…6,7 Drugs known to cause myoclonus are levodopa, antihistamines, antiepileptic drugs, opioids, tricyclic antidepressants and selective serotonin receptor inhibitors. 6,7 Due to the rarity of baclofen-induced myoclonus, it is necessary to exclude these more common causes of myoclonus before attributing the myoclonus to be baclofen induced.…”

Section: Introductionmentioning

confidence: 99%

Baclofen-induced myoclonus in patients with renal impairment: A case series

Vidanapathirana,

Palliyaguruge,

Wijewickrama

2023

SAGE Open Medical Case Reports

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Baclofen is a derivative of gamma amino butyric acid and is used for control of pain and muscular spasms. It is primarily excreted via the kidneys. In patients with impaired renal functions, the half-life of baclofen is prolonged and symptoms of toxicity can occur with normal doses. Commonly reported symptoms of baclofen toxicity are somnolence, altered mentation, seizures and respiratory depression. Myoclonus secondary to baclofen toxicity is scarcely reported. This case series describes two patients with chronic kidney disease (CKD) who were prescribed regular doses of baclofen for analgesia, and subsequently developed generalized myoclonus. The symptoms resolved with omission of baclofen and haemodialysis. There is currently no consensus on dose modification of baclofen in renal impairment for prevention of adverse neurological events. However, considering the surmounting evidence for low threshold of baclofen toxicity in CKD, dose adjustment protocols or consensus on contraindication need to be established.

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Segmental Myoclonus

Cited by 11 publications

References 97 publications

Spinal myoclonus: a rare presentation of cervical myelopathy

Spinal myoclonus: a rare presentation of cervical myelopathy

Myoclonus- A Review

Baclofen-induced myoclonus in patients with renal impairment: A case series

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