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Myoclonus (Nocturnal Myoclonus)

Involuntary shock-like contractions, irregular in rhythm and amplitude, followed by relaxation, of a muscle or a group of muscles. This condition may be a feature of some CENTRAL NERVOUS SYSTEM DISEASES; (e.g., EPILEPSY, MYOCLONIC). Nocturnal myoclonus is the principal feature of the NOCTURNAL MYOCLONUS SYNDROME. (From Adams et al., Principles of Neurology, 6th ed, pp102-3).

Also Known As:

Nocturnal Myoclonus; Myoclonic Jerk; Myoclonus, Sleep; Myoclonic Jerking; Myoclonus Simplex; Myoclonus, Eyelid; Myoclonus, Intention; Myoclonus, Lower Extremity; Myoclonus, Oculopalatal; Myoclonus, Segmental; Myoclonus, Upper Extremity; Action Myoclonus; Extremity Myoclonus, Lower; Extremity Myoclonus, Upper; Eyelid Myoclonus; Intention Myoclonus; Jerk, Myoclonic; Jerking, Myoclonic; Jerks, Myoclonic; Lower Extremity Myoclonus; Myoclonic Jerks; Oculopalatal Myoclonus; Palatal Myoclonus; Segmental Myoclonus; Simplex, Myoclonus; Sleep Myoclonus; Upper Extremity Myoclonus; Myoclonus, Action; Myoclonus, Nocturnal; Myoclonus, Palatal; Polymyoclonus

Networked: 1692 relevant articles (151 outcomes, 113 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Seizures (Seizure)
2.	Dystonia (Limb Dystonia)
3.	Myoclonus (Nocturnal Myoclonus)
4.	Tremor (Tremors)
5.	Movement Disorders (Movement Disorder)

Experts

1.	Klein, Christine: 10 articles (10/2015 - 11/2002)
2.	Vincent, Angela: 8 articles (08/2014 - 12/2011)
3.	Striano, Pasquale: 8 articles (10/2013 - 12/2005)
4.	Vidailhet, Marie: 7 articles (06/2015 - 03/2004)
5.	Tijssen, Marina A J: 7 articles (02/2015 - 05/2004)
6.	Bhatia, Kailash P: 7 articles (08/2014 - 10/2008)
7.	Roze, Emmanuel: 6 articles (06/2015 - 10/2007)
8.	Truong, Daniel D: 6 articles (12/2014 - 02/2007)
9.	Zara, Federico: 6 articles (10/2013 - 02/2007)
10.	Striano, Salvatore: 6 articles (10/2013 - 12/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Myoclonus:

1.	Clonazepam (Rivotril)FDA LinkGeneric 06/01/2007 - "Subsequent therapy with low-dose clonazepam was highly effective in reducing myoclonic jerks and exaggerated startle reaction, and unlike previously used drugs, it was decisive in reducing hypertonia." 01/01/1986 - "Clonazepam improved myoclonus in 10 of 13 patients, two of whom had complete resolution of symptoms. " 03/01/1977 - "Clonazepam is very effective in controlling the myoclonus. " 02/01/1988 - "Clonazepam was effective in controlling the myoclonic jerks, which were a feature in this patient, without producing excessive sedation. " 01/01/2011 - "Clonazepam may be helpful with all types of myoclonus. "
2.	Piracetam (Nootropil)IBA 01/01/2006 - "He presented with severe myoclonus, which was resistant to conventional therapy and dramatically improved after administration of 12-18 gm/die piracetam. " 10/01/2000 - "In the placebo-controlled double-blind crossover trial of piracetam conducted in the UK, there was a significant improvement in cortical myoclonus. " 10/01/2000 - "These results show that piracetam has a beneficial use in clinics for severe myoclonus patients when it is combined with anti-epileptic drugs, demonstrating an improvement in the myoclonus and QOL of patients." 07/01/1996 - "Treatment with piracetam in 5 patients significantly improved myoclonus. " 05/01/2001 - "Piracetam given as add-on therapy seems to be an effective, sustained, and well-tolerated treatment of myoclonus. "
3.	Valproic Acid (Valproate, Semisodium)FDA LinkGeneric 08/01/1988 - "Of all the drugs which are usually thought to be effective in the treatment of myoclonus, only valproic acid brought some relief. " 01/01/2009 - "With sodium valproate and clonezepam, her myoclonic jerks improved slightly. " 04/01/2003 - "However, after the administration of valproate, his cortical myoclonus improved, and the transient akinetorigid state also disappeared simultaneously. " 08/10/1978 - "Post-anoxic action myoclonus: improvement with valproic acid." 06/01/1999 - "Inclusion criteria in the study were: a) myoclonic jerks, preferably on awakening; b) beginning of the symptoms between 8 and 26 year-of-age; c) typical pattern of electroencephalographic discharges; and d) good response to sodium valproate (VPA). "
4.	etiracetam (levetiracetam)FDA LinkGeneric 05/01/2012 - "The administration of levetiracetam alleviated positive myoclonus and suppressed atonic falls, resulting in a remarkable improvement in the patient's quality of daily life. " 03/01/2002 - "Add-on therapy with levetiracetam significantly improved the patient's clinical condition, suppressed cortical myoclonus-associated spikes, and enabled further neurorehabilitation." 06/01/2004 - "Disabling myoclonus is the main symptom in long-standing Unverricht-Lundborg disease (ULD), and levetiracetam (LEV) appears to be an effective anticonvulsant with promising short-term antimyoclonic properties. " 05/01/2003 - "Case reports provide additional information regarding the potential efficacy of levetiracetam in postanoxic, post-encephalitic and progressive myoclonus. " 04/01/2003 - "Levetiracetam is a new antiepileptic drug with a broad-spectrum activity that includes efficacy against positive myoclonus. "
5.	Etomidate FDA LinkGeneric 12/01/2015 - "Myoclonus (6 trials) and painful injection (4 trials) were commonest adverse effects with etomidate. " 05/01/2013 - "A descriptive study of myoclonus associated with etomidate procedural sedation in the ED." 01/01/1999 - "In Study 2, two volunteers (25%) with etomidate pretreatment had mild myoclonus compared to six (75%) with placebo pretreatment (P < or = 0.05). " 01/01/1999 - "In Study 1, myoclonus was not observed after 0.025 or 0.050 mg/kg etomidate. " 02/01/2015 - "The occurrence and severity (observational score of 0-3) of myoclonus was assessed for 2 min after administration of etomidate. "
6.	BenzodiazepinesIBA 02/01/2014 - "With or without treatment using benzodiazepines, myoclonus in all patients resolved completely within 1-4 days, although five had recurrence 2-19 months after their first episodes. " 07/01/1990 - "Benzodiazepines (BDZs) are often helpful in the treatment of myoclonus. " 01/01/1986 - "Stimulus-sensitive myoclonus of the baboon Papio papio: pharmacological studies reveal interactions between benzodiazepines and the central cholinergic system." 01/01/2012 - "Administration of benzodiazepine for the myoclonus resulted in immediate and complete disappearance of the symptoms. " 09/01/2011 - "The patient was treated with a benzodiazepine to control the myoclonus without response. "
7.	Botulinum Toxins (Botulinum Toxin)IBA 09/01/2012 - "Botulinum toxin is effective in myoclonus secondary to peripheral nerve injury." 01/23/2009 - "Botulinum toxin has proved to be effective in palatal myoclonus. " 03/01/1994 - "This observation indicates the efficacy of botulinum toxin in the treatment of painful spinal myoclonus." 10/01/2015 - "In response to Palatal myoclonus: Algorithm for management with botulinum toxin based on clinical disease characteristics." 10/01/2015 - "In reference to Palatal myoclonus: Algorithm for management with botulinum toxin based on clinical disease characteristics."
8.	Carbidopa (Lodosyn)FDA LinkGeneric 12/01/1982 - "This rank order of potency differed from that observed for the order of potency of these drugs in inhibiting the myoclonus induced by L-5-hydroxytryptophan (5HTP) plus carbidopa in guinea-pigs (Luscombe, Jenner and Marsden, Neuropharmacology, 1981), perhaps indicating involvement of pharmacologically distinct indoleamine receptors. " 06/01/1980 - "Six patients with myoclonus of varying cause were treated with L-5-hydroxytryptophan (L-5-HTP) and carbidopa. " 06/01/1980 - "Treatment of myoclonus with L-5-hydroxytryptophan and carbidopa: clinical, electrophysiological, and biochemical observations." 02/01/1975 - "Therapy of intention myoclonus with L-5-hydroxytryptophan and a peripheral decarboxylase inhibitor, MK 486." 01/13/1977 - "In 18 patients with intention myoclonus due to anoxia or other brain damage, 11 derived more than 50% overall improvement during treatment with L-5HTP and carbidopa. "
9.	5-Hydroxytryptophan (5 Hydroxytryptophan)IBA 02/01/1996 - "Guinea pigs respond to 5-hydroxytryptophan (5-HTP) with a complex behavioural syndrome which includes distinctive whole-body jerks (myoclonic jerks). " 12/29/1995 - "Our data therefore confirm previous reports concerning the effects of 5-HT2A/2C receptor blockade on 5-HTP induced myoclonic jerks and suggest that both 5-HT1D and 5-HT1A receptors play an important role in mediating this behavioural response." 12/29/1995 - "Systemic administration of 5-hydroxytryptophan (5-HTP) to guinea pigs causes species-specific, rhythmic, whole body jerks (myoclonic jerks), the frequency and amplitude of which were measured in an automated apparatus. " 12/29/1995 - "The role of 5-HT1D and 5-HT1A receptors in mediating 5-hydroxytryptophan induced myoclonic jerks in guinea pigs." 07/01/1990 - "Further experience showed that only a few patients with myoclonus benefit from 5-HTP therapy. "
10.	Carbamazepine (Tegretol)FDA LinkGeneric 08/16/2014 - "Compared with placebo, carbamazepine and gabapentine have not demonstrated effectiveness although they may be effective in some patients with auditory nerve vascular compression or myoclonus. " 06/01/2012 - "Although a pathogenetic mechanism underlying carbamazepine-induced epileptic negative myoclonus has been proposed, a causative role of carbamazepine for positive myoclonus has not been fully identified. " 03/01/2006 - "The favorable effect of the carbamazepine on myoclonus was demonstrated by discontinuing and reintroducing carbamazepine, and videoing the consequent reappearance and disappearance of the myoclonus. " 08/01/1998 - "Frequency of absences increased in four children treated with carbamazepine and two of these developed myoclonic jerks, which resolved on withdrawal of carbamazepine. " 09/01/1991 - "Palatal myoclonus was not controlled by carbamazepine in therapeutic doses, but disappeared when the patient was asleep. "

Therapies and Procedures

1.	Deep Brain Stimulation 04/01/2009 - "Bilateral deep brain stimulation (DBS) of the ventral intermediate nucleus of the thalamus was performed, and the patient demonstrated moderate clinical improvement in myoclonus. " 06/01/2015 - "Alleviation of myoclonus after bilateral pallidal deep brain stimulation for Lance-Adams syndrome." 08/01/2014 - "Recent studies confirm lasting therapeutic effects of deep brain stimulation in isolated dystonia, good treatment response in myoclonus-dystonia, and suggest that early treatment correlates with a better outcome. " 11/01/2014 - "In severely affected patients, deep brain stimulation of the globus pallidus internus has been used successfully to treat both dystonia and myoclonus. " 12/01/2011 - "The possibility of spontaneous improvement should be kept in mind when considering the therapeutic strategy in myoclonus-dystonia patients, especially when contemplating deep-brain stimulation."
2.	Anesthesia 01/01/2013 - "Myoclonus is an extremely rare perioperative complication following neuraxial anesthesia. " 02/04/1982 - "Choralose, a widely used anesthetic in neurophysiology, produces a unique pattern of anesthesia characterized by both an excitant (myoclonic jerks and startle response) and depressant (sedation and anesthesia) action. " 07/01/1953 - "Influence of anesthesia on cortical irradiation and reflex myoclonus." 06/01/2015 - "Two groups were compared for pain on injection and myoclonus, Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP), Cardiac Index (CI) and Systemic Vascular Resistance (SVR), before and one minute after induction of anesthesia, and one, three and five minutes after intubation. " 09/01/2012 - "After recovery from anesthesia the dog showed signs of severe pruritus of the tail base and limbs and myoclonus of the tail and hind limbs. "
3.	Injections 03/01/2013 - "Those injections reduced the myoclonus, helping the dog become ambulatory and attaining a comfortable, functional state." 03/01/2000 - "Rostral thalamic injections induced more severe dystonic postures, whereas myoclonic jerks predominated following caudal injections. " 01/01/2000 - "We present here a case of palatal myoclonus with distressing tinnitus in a 12-year-old girl and its successful treatment with electromyography (EMG)-guided injections of Clostridium botulinum toxin." 01/01/1998 - "The injections should be performed under EMG control in patients with limb, oro-mandibular and laryngeal dystonia and with palatal myoclonus." 12/01/1993 - "We report our experience with B injections in 2 women, aged 20 and 21, respectively, 1 of whom had bilateral palatal myoclonus and the other adductor spastic dysphonia. "
4.	Drug Therapy (Chemotherapy) 07/01/1990 - "Not until patients with myoclonus and major functional disability were reported in the 1960s was attention given to understanding its basis and pharmacotherapy. " 12/01/1989 - "A 24-yr-old woman suffering from traumatic spinal myoclonus which occurred after a diving injury, and which had not responded to pharmacotherapy, apparently resolved after treatment by manipulation of the spine. " 07/15/2007 - "Chemotherapy and lung lobectomy resulted in complete tumor remission and disappearance of myoclonus. " 01/01/2013 - "A 53-year-old woman initially presenting with psychiatric symptoms developed myoclonus and was admitted 1 month later to the ICU with a suspected nonconvulsive status epilepticus and respiratory insufficiency, probably due to extensive antiepileptic drug therapy. " 03/01/1994 - "We suggest that the onset of one movement disorder after drug therapy (eg, myoclonus) may predict the development of other movement disorders (e.g., catatonia). "
5.	General Anesthesia 07/01/2014 - "We report the case of a young woman with fibrodysplasia ossificans progressiva who had recurrent, debilitating myoclonus that was refractory to conventional therapies but was relieved for prolonged periods after general anesthesia was administered. " 07/01/2014 - "General anesthesia treatment of propriospinal myoclonus in a patient with fibrodysplasia ossificans progressiva." 02/01/2015 - "Myoclonus induced by etomidate during induction of general anesthesia is undesirable. " 02/01/2015 - "The results suggest that infusion of 0.1 mg kg(-1) dezocine 1 min before etomidate administration is effective for suppressing myoclonus induced by etomidate during induction of general anesthesia without significant side-effects." 02/01/2013 - "Myoclonus induced by etomidate under general anesthesia can be prevented by target controlled infusion of remifentanil, with 2-3 f.Lg/L being the optimal concentration."