Myoclonus and nocturnal myoclonus: muscle spasms during sleep

Myoclonus consists of a brief, rapid, involuntary and sudden and shock-like movement, consisting of single or repetitive muscle discharges. Generally, myoclonus is physiological and not a cause for concern, however forms of myoclonus may occur due to a disorder of the central nervous system, such as epilepsy, metabolic problems or reaction to medications.

Hiccups are a form of myoclonus, as are sudden bumps, which happen when a person is falling asleep. These forms of myoclonus occur in healthy people and are not a problem.

Treatment usually consists of treating the cause or disease that is at its origin, however, in some cases it is not possible to resolve the cause and treatment consists only of relieving symptoms.

What symptoms

Generally, people with myoclonus describe a kind of sudden, brief, involuntary muscle spasm, as if it were a shock, which can vary in intensity and frequency, which can be only in one part of the body or in several, and in very severe cases, it can interfere with food and the way of talking or walking.

Possible causes

Myoclonus can be caused by several problems, and can be classified, according to the cause, into several types:

1. Physiological myoclonus

This type of myoclonus occurs in normal, healthy people and rarely needs treatment, such as:

• Hiccups; Spasms during sleep onset, also called nocturnal myoclonus; Tremors or spasms due to anxiety or physical exercise; Infantile spasms during sleep or after eating.

2. Idiopathic myoclonus

In idiopathic myoclonus, myoclonic movement appears spontaneously, without being associated with other symptoms or diseases, and may interfere with daily activities. Its cause is still unknown, but it is usually associated with hereditary factors.

3. Epileptic myoclonus

This type of myoclonus occurs partly due to an epileptic disorder, where seizures are produced that cause rapid movements, both in the arms and legs. Learn to identify the symptoms of epilepsy.

4. Secondary myoclonus

Also known as symptomatic myoclonus, it usually occurs as a result of another disease or medical condition, such as injury to the head or spinal cord, infection, kidney or liver failure, Gaucher disease, poisoning, prolonged oxygen deprivation, reaction to medication, illness autoimmune and metabolic.

In addition to these, there are other conditions related to the central nervous system, which can also result in secondary myoclonus, such as stroke, brain tumor, Huntington's disease, Creutzfeldt-Jakob disease, Alzheimer's and Parkinson's disease, corticobasal degeneration and frontotemporal dementia.

What is nocturnal myoclonus

Nocturnal myoclonus or muscle spasms during sleep, is a disorder that occurs during sleep, when the person feels that he is falling or out of balance and normally happens when he is falling asleep, in which the arms or legs move involuntarily, as if they were muscle spasms.

The cause of these movements is not yet known, but it is thought that it consists of a kind of cerebral conflict, in which the system that keeps the person awake interferes with the system that induces sleep, which can happen because, even during sleep, when you start dreaming, the motor system exerts some control over the body even when the muscles start to relax.

How the treatment is done

There are many cases in which treatment is not necessary, however, when it is justified, it usually consists of treating the cause or the disease that is at its origin, however, in some cases it is not possible to resolve the cause and only symptoms. The drugs and techniques used are as follows:

Tranquilizers: Clonazepam is the most prescribed medication in these cases, to combat the symptoms of myoclonus, however it can cause side effects, such as loss of coordination and drowsiness.

Anticonvulsants: These are drugs that control epileptic seizures, which also help to reduce the symptoms of myoclonus. The anticonvulsants most used in these cases are levetiracetam, valproic acid and primidone. The most common side effects of valproic acid are nausea, levetiracetam is tiredness and dizziness and primidone is sedation and nausea.

Therapies: Botox injections can help treat various forms of myoclonus, especially when only one part of the body is affected. Botulinum toxin blocks the release of a chemical messenger that causes muscle contraction.

Surgery: If myoclonus symptoms are caused by a tumor or an injury to the brain or spinal cord, surgery in these cases may be an option.