Physiological Myoclonus |
- Clinical diagnosis based on history
- No specific investigations needed
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- Usually no treatment required
- Reassurance for benign nature (e.g., sleep starts, hiccups)
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Essential Myoclonus |
- Clinical diagnosis
- Exclusion of other causes through history and examination
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- Clonazepam
- Valproic acid
- Levetiracetam
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Epileptic Myoclonus |
- Electroencephalogram (EEG)
- MRI brain for structural abnormalities
- Genetic testing if hereditary epilepsy syndromes are suspected
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- Antiepileptic drugs (e.g., valproic acid, levetiracetam, clonazepam)
- Manage underlying epilepsy syndrome
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Symptomatic (Secondary) Myoclonus |
- MRI brain to identify structural lesions
- Metabolic panel (Glucose, U&E, LFTs)
- Toxicology screening
- CSF analysis for infection/inflammation
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- Treat underlying cause (e.g., correcting metabolic imbalance, removing offending drugs)
- Symptomatic treatment with clonazepam, valproic acid
- Physical therapy for functional improvement
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Psychogenic Myoclonus |
- Diagnosis of exclusion after ruling out organic causes
- Psychiatric evaluation
- EEG-video monitoring may help differentiate from epileptic myoclonus
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- Cognitive-behavioral therapy (CBT)
- Psychotherapy
- Consider anxiolytics or antidepressants if indicated
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