Treatment options for epileptic myoclonus and epilepsy syndromes associated with myoclonus

Abstract

Epileptic myoclonus is a manifestation of cortical irritability. The precise etiology is important when determining the best course of treatment. Response to treatment is variable and usually depends on the epileptic syndrome. Some antiepileptic drugs may worsen myoclonus even in patients with syndromes where most patients have a good response to that same drug. Therefore, clinicians must always have in mind that worsening in myoclonus may be ameliorated by decrease or withdrawal rather than increase of medication.

Spinal Myoclonus Developed during Cervical Epidural Drug Infusion in Postherpetic Neuralgia Patient

“…Treatment of myoclonus focuses on medications that may help reduce symptoms. The various drugs used include anticonvulsants such as sodium valproate, clonazepam, and benzodiazepines, which include diazepam and midazolam [14]. …”

A pilot open-label trial of zonisamide in Unverricht-Lundborg disease

“…So far, therapy of epilepsy and action myoclonus in EPM1 patients continues to be challenging. Conventional AEDs may be poorly effective in monotherapy or even in combination 1. Systematic controlled studies about the effects of new AEDs on myoclonus in PMEs patients are lacking.…”

“…Action myoclonus may be due to multiple etiological factors enhancing motor cortex excitability. It is often intractable and related to severe functional disability 1. Unverricht‐Lundborg disease (EPM1) is the most common form of progressive myoclonus epilepsies.…”

Sustained Effect of Botulinum Neurotoxin in Myoclonus Owing to Epilepsia Partialis Continua

“…The myoclonic muscle activity in EPC, sometimes aggravated by sensory stimulation or movement, often causes serious disability and limits the patient's autonomy. Unfortunately, although the disorder is classified as a focal status epilepticus, antiepileptic drugs (AEDs) are notoriously ineffective in patients with EPC, and there is little evidence to guide therapy . EPC often resembles a movement disorder, such as hemifacial spasm or tremor, and discrimination can be difficult .…”