Ohio State’s Movement Disorders Clinic has an experienced team who specialize in treating all types of movement disorders.

Myoclonus is a muscle twitch or sudden, involuntary jerking of a muscle or group of muscles. Myoclonic twitches or jerks usually are caused by sudden muscle contractions, called positive myoclonus, or by muscle relaxation, called negative myoclonus.

Myoclonic jerks may occur alone or in sequence, in a pattern or without pattern. They may occur infrequently or many times each minute. Myoclonus sometimes occurs in response to an external event or when a person attempts to make a movement. The twitching cannot be controlled by the person experiencing it.

In some cases, myoclonus begins in one region of the body and spreads to muscles in other areas. More severe cases of myoclonus can affect movement and limit a person's ability to move or walk. These types of myoclonus may indicate an underlying disorder in the brain or nerves.

Myoclonic jerking often is a symptom of a nervous disorder, such as multiple sclerosis, Parkinson's disease, Alzheimer's disease or Creutzfeldt-Jakob disease. Myoclonic jerks commonly occur in persons with epilepsy, a disorder in which the electrical activity in the brain becomes disordered, leading to seizures.

Causes

In addition to being caused by epileptic seizures, myoclonus also can be triggered by:

  • Infection
  • Stress
  • Head or spinal cord injury
  • Stroke
  • Brain tumors
  • Kidney or liver failure
  • Lipid storage disease
  • Sleep disturbances
  • Chemical or drug poisoning
  • Prolonged oxygen deprivation to the brain

Source: National Institute of Neurological Disorders and Stroke




Why Choose Ohio State

Why choose Ohio State for treatment of myoclonus?

Physician Expertise: All of our movement disorders specialists are board certified neurologists who have received additional fellowship training in movement disorders.

Multidisciplinary Team: Because movement disorders overlap with a number of other nervous system disorders, we have an integrated network of neurology subspecialists who work together, including epilepsy specialists and sleep medicine specialists. In addition, we have physical therapists who specialize in movement disorders and a neurology social worker who connects you to medical and community resources.

Types of Myoclonus

Types of Myoclonus

Types of Myoclonus

Action Myoclonus

The most disabling type of myoclonus, characterized by muscular jerking in the arms, legs or face, triggered by voluntary movement, especially attempts at precise, coordinated movements. It often is due to brain damage caused by a lack of oxygen and blood flow to the brain.

Cortical Reflex Myoclonus

Thought to be a type of epilepsy that originates in the cerebral cortex (the outer layer of the brain), responsible for much of the information processing that takes place in the brain. Jerking usually involves only a few muscles in one part of the body, but jerks involving many muscles also may occur.

Essential Myoclonus

Occurs in the absence of epilepsy or other apparent abnormalities in the brain or nerves. It sometimes runs in families or occurs randomly in people with no family history. Essential myoclonus tends to be stable without increasing in severity.  

Palatal Myoclonus

Regular, rhythmic and rapid contraction of one or both sides of the rear of the roof of the mouth (the soft palate). Contractions can be uncomfortable and sometimes painful, and may be accompanied by myoclonus in other muscles, including those in the face, tongue, throat and and diaphragm. The condition usually appears in adults and can last indefinitely.   


Progressive Myoclonus Epilepsy

A group of diseases characterized by myoclonus, epileptic seizures and other serious symptoms such as trouble walking or speaking. These rare disorders often get worse over time and sometimes are fatal.  


Reticular Reflex Myoclonus

Thought to be a type of generalized epilepsy that originates in the brain stem, which controls vital functions such as breathing and heartbeat. Myoclonic jerks are triggered by voluntary movement or an external stimulus and usually affect the whole body, with muscles on both sides of the body affected simultaneously.  


Stimulus-sensitive Myoclonus

Triggered by a variety of external events, including noise, movement and light. Surprise may increase the sensitivity of the individual.  


Sleep Myoclonus

Occurs during the initial phases of sleep, especially at the moment of dropping off to sleep. Some forms appear to be stimulus-sensitive. Some people are rarely troubled by the condition and others may require treatment by a doctor.  


Diagnosis

Diagnosing Myoclonus

During a history and physical exam, our movement disorders neurologists observe your movements in the exam room or on a video you bring. We may recommend further diagnostic options to help us better define an underlying cause of your movements or to rule out disorders:

  • Magnetic resonance imaging (MRI) of the brain or spine
  • Electroencephalogram (EEG) to study your brain waves
  • Electromyograph (EMG) to assess muscle activity
  • Blood tests

In some cases, we may refer you to our Sleep Disorders Center or to our Comprehensive Epilepsy Center for further evaluation. 

Treatment

Treating Myoclonus

Myoclonus can be difficult to treat. Our goal in many cases is to reduce your level of movement so you can perform activities of daily living.

Medications

Medications we prescribe include:

  • Clonazepam, a medication that helps calm nervous system activity and can act as a muscle relaxant. Dosage is increased gradually to achieve maximum benefit.
  • Levetiracetam, phenytoin and primidone, medications also used to treat epilepsy. They slow down your central nervous system and help prevent seizures.
  • Sodium valproate, a medication used to treat seizures and other central nervous system disorders, is an alternative therapy for myoclonus that can be used either alone or in combination with clonazepam.
  • Botulinum toxin injections are sometimes used to calm excessive muscle activity if the myoclonus is restricted to only one region of the body. 

Physical Therapy

One of Ohio State’s strengths is our physical therapy program, which includes therapists who specialize in movement disorders. We help you maintain your highest level of function and movement. We will assess you through a variety of tests and recommend the best therapies for your needs. These may include:

  • Training you to walk with regular steps to improve your balance and prevent falls
  • Working with you to safely transfer on and off of chairs and toilets to help you to be more independent.
  • Assessing you to recommend appropriate walking or assistive devices
  • Teaching you exercises to improve strength, flexibility, coordination and balance, and maintain fitness and health.  

Neuropsychiatrists

If stress or anxiety is worsening your movements, we can refer you to one of our neuropsychiatrists, who will help you identity behavioral triggers that may increase your distress, help you identify ways including behavioral modification strategies to cope with your movements, and medications such as a serotonergic reuptake inhibitor to help with your symptoms.  


Research

Research

Our participation in national and international clinical trials for movement disorders provides you with access to the latest options in medications and treatments, often long before they come to market.

Enroll in a clinical trial

Our Doctors

Additional Information

If your twitching or jerking movements are not occurring frequently, please make a video of the movements using your smart phone or other device and bring it to your appointment. Bring any past records that you have related to neurological or medical issues, including the date your symptoms first started. Be prepared to provide information related to any neurological disorders that other family members have experienced. Please also bring results of any EEG studies or imaging studies (CT, MRI) of the brain or spine, previous lab results and notes from your referring neurologist or other physician.

Preparing for your visit 

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