Contents

Search

myoclonic seizure

See also myoclonus. Classification: - considered generalized seizure involving the entire body Etiology: 1) hypoxia 2) lipid storage disease 3) encephalitis 4) Creutzfeldt-Jakob disease 5) metabolic encephalopathy due to: a) respiratory failure b) chronic renal failure c) hepatic failure d) electrolyte imbalance 6) occasionally normal action 7) associated with sleep deprivation, alcohol use, visual stimuli & stress [4] Epidemiology: - most common adult generalized epilepsy - onset in teenagers & young adults Clinical manifestations: 1) sudden, brief, irregular involuntary contractions of the limbs, trunk or facial muscles - duration may be very short (1 second) [4] - described as twitches, spasms, jerks or shakes - suddenly dropping an item is a common symptom 2) may occur more often upon awakening [4] 3) generally no loss of consciousness Special laboratory: - electroencephalography (EEG) after a period of sleep Differential diagnosis: - myoclonus is a twitch of a single muscle group that may or may not be due to seizure activity - myoclonus of sleep is normal as is the EEG Management: 1) agents of choice a) valproate (Depakote) b) baclofen c) clonazepam 2) Alternative agents - phenobarbital 3) patients with juvenile myoclonic epilepsy require lifelong anticonvulsant therapy [4] * lamotrigine may worsen myoclonic seizures [4]

General

primary generalized seizure myoclonus

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1034-35
  2. Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 122
  3. Alan Gelb, UCSF, Department of Emergency Services, San Francisco General Hospital, 1998
  4. Medical Knowledge Self Assessment Program (MKSAP) 19. American College of Physicians, Philadelphia 2021 - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022