Myoclonus is a convulsive repetitive twitching of large muscle groups. The condition can be observed normally when falling asleep, severe fright. If the cause of the disease is a lesion of the cerebral cortex, then it is customary to talk about cortical myoclonus (myoclonus).

This disease is a type of hyperkinesis. Cortical myoclonus is characterized by a particularly rapid seizure. Patients describe the sudden muscle contraction as " A number of pathological causes contribute to the development of myoclonus. Acquired myoclonic seizures can occur at any age. In adults, they are often associated with metabolic disorders.. For example, myoclonus is recorded with uremia, ketoacidosis, hyperosmolar coma, lactic acidosis, hypoxia. In these conditions, the cerebral cortex is damaged by toxic concentrations of metabolic products (nitrogenous bases, ketone bodies). In newborns, myoclonic seizures are quite common and are associated with neurodegenerative diseases (Alpers disease, Tay-Sachs disease).

Myoclonus can occur as a variant of primary generalized epilepsy and become a manifestation of juvenile myoclonic epilepsy or absences with a myoclonic component. Also, twitching of large muscle groups is possible with the progression of various neurological diseases.. Most often, cortical myoclonus is observed with diffuse brain damage, especially when gray matter is involved in the process. Such lesions of the cerebral cortex occur in diseases of accumulation (hemochromatosis, amyloidosis, leukodystrophy and others) and infectious processes (Kozhevnikovskaya epilepsy against the background of a progressive form of tick-borne encephalitis, and others).

Differential diagnosis of myoclonus Differential diagnosis of cortical myoclonus is necessary with tremor, tic, tetany, focal motor seizures.

Symptoms of myoclonus include short, involuntary muscle contractions that suddenly occur in various parts of the body.. According to the degree of involvement of different muscle groups in the process, myoclonus is generalized, regional and local. Localized myoclonus often manifests itself in the rapid contractions of the muscles of the face, tongue, soft palate. Speech (articulation) disorders may occur. Generalized seizures involve several muscle groups at once. With metabolic disorders (uremia, hypoxia), the most muscles are involved in the process. Most often, involuntary contractions occur in the muscles of the trunk, thigh, shoulder, face. Sometimes the cramp takes over the diaphragm. Like all hyperkinesis, myoclonus increases with emotional experiences. In a dream, symptoms are most often absent..

Diagnosis of myoclonus Diagnosis of myoclonus is based on the doctor's observation of short-term muscle twitching or the description of such by the patient. To clarify the diagnosis, electroencephalography is performed. To identify the cause of seizures, it is necessary to do a blood test - to determine the level of creatinine and blood urea, blood sugar and some other indicators. Also shown are imaging techniques - X-ray of the skull, computed or magnetic resonance imaging of the brain. The examination for this disease should be carried out by a neurologist.. In some cases, hospitalization in a neurological hospital may be necessary to clarify the diagnosis.

Treatment of myoclonus Treatment of myoclonus depends on the cause. If myoclonus is associated with metabolic disorders, then the correction of the primary disease leads to a clear improvement in the neurological picture. So with uremia (increased levels of creatinine and blood urea), active treatment of renal failure is indicated, including peritoneal dialysis, hemodialysis, kidney transplantation.

For primary generalized epilepsy with myoclonic seizures, sodium valproate is the most effective drug. Various anticonvulsants have a therapeutic effect in all forms of the disease - topiramate, lamotrigine, zonisamide and levetiracetam.. Benzodiazepines can be used for a quick effect.

Prognosis of the disease The prognosis of the disease depends on the etiology of myoclonus. The most unfavorable prognosis in myoclonus against the background of generalized neurodegenerative disease.

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