| Physiological Myoclonus | 
Clinical diagnosis based on historyNo specific investigations needed | 
Usually no treatment requiredReassurance for benign nature (e.g., sleep starts, hiccups) | 
 | Essential Myoclonus | 
Clinical diagnosisExclusion of other causes through history and examination | 
ClonazepamValproic acidLevetiracetam | 
 | Epileptic Myoclonus | 
Electroencephalogram (EEG)MRI brain for structural abnormalitiesGenetic testing if hereditary epilepsy syndromes are suspected | 
Antiepileptic drugs (e.g., valproic acid, levetiracetam, clonazepam)Manage underlying epilepsy syndrome | 
 | Symptomatic (Secondary) Myoclonus | 
MRI brain to identify structural lesionsMetabolic panel (Glucose, U&E, LFTs)Toxicology screeningCSF analysis for infection/inflammation | 
Treat underlying cause (e.g., correcting metabolic imbalance, removing offending drugs)Symptomatic treatment with clonazepam, valproic acidPhysical therapy for functional improvement | 
 | Psychogenic Myoclonus | 
Diagnosis of exclusion after ruling out organic causesPsychiatric evaluationEEG-video monitoring may help differentiate from epileptic myoclonus | 
Cognitive-behavioral therapy (CBT)PsychotherapyConsider anxiolytics or antidepressants if indicated |