Myoclonia

The myoclonia is a convulsive repeated twitching of large groups of muscles. The state can be observed normal when backfilling, a strong fright. If damage of a cerebral cortex is a cause of illness, then it is accepted to speak about a cortical myoclonia (myoclonus). This disease is one of types of hyperkinesias. The cortical myoclonia is characterized by special speed of a spasm. Patients describe sudden reduction of a muscle as "blow by current". A number of the pathological reasons promote development of a myoclonia. The acquired myoclonic spasms can arise at any age. They often occur at adults against the background of metabolic disturbances. For example, the myoclonia is fixed at uraemia, ketoacidosis, a giperosmolyarny coma, a lactacidemia, a hypoxia. At these states the cerebral cortex is injured by toxic concentration of products of exchange (the nitrogenous bases, ketonic bodies). Myoclonic spasms occur at newborns rather often and are connected with neurodegenerative diseases (Alpers's disease, a disease Teja-Saks). The myoclonia can arise as option of primary generalized epilepsy and to become display of juvenile myoclonic epilepsy or absentias epileptica with a myoclonic component. Also twitchings of large groups of muscles are possible when progressing various neurologic diseases. Most often the cortical myoclonia is observed at diffusion injuries of a brain, especially when involving in process of gray matter. Such damages of a cerebral cortex happen at accumulation diseases (hemochromatosis, an amyloidosis, a leukodystrophy and other) and infectious processes (kozhevnikovsky epilepsy against the background of a progreduated form of a tick-borne encephalitis and others).

Differential diagnosis of a myoclonia

The differential diagnosis of a cortical myoclonia is necessary with a tremor, a tic, a tetany, focal motor spasms.

Disease symptomatology

The symptomatology of a myoclonia includes the short involuntary reductions of muscles which are suddenly arising in various parts of a body. On degree of an involvement into process of different groups of muscles the myoclonia happens generalized, regional and local. The localized myoclonia is shown in bystry reductions of face muscles, language, a soft palate more often. There can be disturbances of the speech (articulation). Generalized attacks involve in a spasm several groups of muscles at once. At metabolism disturbances (uraemia, a hypoxia) most of all muscles are involved in process. Most often involuntary reductions happen in muscles of a trunk, a hip, a shoulder, the person. Sometimes the spasm takes a diaphragm. As well as all hyperkinesias, a myoclonia amplifies at emotional experiences. In a dream the symptomatology most often is absent.

Diagnosis of a myoclonia

Diagnosis of a myoclonia is based on medical supervision of short-term twitchings of muscles or the description of those by the patient. For specification of the diagnosis the electroencephalography is carried out. To establish the reason of spasms it is necessary to make blood test – to determine the level of creatinine and urea of blood, sugar of blood and some other indicators. The visualizing techniques – a skull X-ray analysis, a computer or magnetic and resonant tomography of a brain are also shown. At this disease the neurologist has to conduct examination. In certain cases hospitalization in a neurologic hospital can be necessary for specification of the diagnosis.

Treatment of a myoclonia

Treatment of a myoclonia depends on a cause of illness. If the myoclonus is connected with exchange disturbances, then correction of primary disease leads to explicit improvement of a neurologic picture. So at uraemia (the increased level of creatinine and urea of blood) active treatment of a renal failure, including peritoneal dialysis, a hemodialysis, transplantation of a kidney is shown. At primary generalized epilepsy with myoclonic spasms the most effective drug is sodium Valproatum. The therapeutic effect at all forms of a disease is rendered by different anticonvulsant drugs - топирамат, ламотриджин, зонисамид and to levetiratseta. For bystry effect it is possible to use benzodiazepines.

Forecast of a disease

The forecast of a disease depends on a myoclonia etiology. The most adverse forecast at a myoclonus against the background of a generalized neurodegenerative disease.