An Update on Myoclonus Management

Expert Rev Neurother. 2019 Apr;19(4):325-331. doi: 10.1080/14737175.2019.1592676. Epub 2019 Mar 20.

Abstract

Myoclonus is a hyperkinetic movement disorder characterized by sudden, brief, lightning-like involuntary jerks. There are many possible causes of myoclonus and both the etiology and characteristics of the myoclonus are important in securing the diagnosis and treatment. Myoclonus may be challenging to treat, as it frequently requires multiple medications for acceptable results. Few randomized controlled trials investigating the optimal treatment for myoclonus are available, and expert experience and case series guide treatment. Areas Covered: In this article, the authors review the basics of myoclonus and its classification. The authors discuss the current management of myoclonus and then focus on recent updates in the literature, including both pharmacologic and surgical options. Expert opinion: Myoclonus remains a challenge to manage, and there is a paucity of rigorous clinical trials guiding treatment paradigms. Furthermore, due to the etiological heterogeneity of myoclonus, defining the appropriate scope for high-quality clinical trials is challenging. In order to advance the field, the myoclonus study group needs to be revived in the US and abroad so that interested investigators can collaborate on multicenter clinical trials for myoclonus treatments.

Keywords: deep brain stimulation; myoclonus; perampanel; treatment; zonisamide.

Publication types

  • Review

MeSH terms

  • Anticonvulsants / therapeutic use*
  • Deep Brain Stimulation*
  • Humans
  • Myoclonus / classification
  • Myoclonus / drug therapy
  • Myoclonus / surgery
  • Myoclonus / therapy*

Substances

  • Anticonvulsants