How is myoclonus treated

How is myoclonus treated? 

Recognition of the different types of myoclonus has practical implications because each of the categories has a unique pathophysiologic mechanism and specific treatment.

Myoclonus related to metabolic encephalopathies improves with treatment of the metabolic disturbance.

Epileptic myoclonus is initially treated with sodium valproate. If toxic reactions occur or the patient is still symptomatic, either clonazepam or primidone may be added.

Clonazepam is the first choice in myoclonus arising from the brain stem, but 5-hydroxytryptophan, clomipramine, and fluoxetine are useful alternatives.

Spinal and other segmental myoclonus also may respond to clonazepam or drugs that enhance serotoninergic transmission, but injections of botulinum toxin in the affected musculature has been the most useful treatment.

Recent studies with levetiracetam for the treatment of cortical myoclonus have shown some promising results as an antimyoclonic agent.

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