Symptoms occur at any age, even in a newly born child. Causes may have a natural and pathological nature.
A person rarely thinks about the processes that are necessary in order to make some movement. Breath, heartbeat is made involuntarily. Learning some kind of action is intentional, but everything that stands behind the intention is not controlled. The process is regulated by a well-functioning work of the neuromuscular system.
However, in some situations, for example, with myoclonia, a failure occurs. Myoclonus is a sudden involuntary contraction of muscle tissue. Spasms appear without control of the person, usually quickly disappear.
Types of myoclonia
The reasons, character, features of manifestation allow to speak about various types of myoclonus. Classify them for a variety of signs.
According to etiology
At present, the classification proposed in 1982 by S.D. Marsden is considered the most popular. Benign and negative myoclonia is distinguished. Both of these species, in turn, are divided into several subspecies.
Benign cortical is a natural reaction of the body to any irritant. About night myoclonia say when a spasm occurs when falling asleep. It usually appears once, lasts less than a minute. Associated with severe fatigue. Often, benign sleep myoclonia occurs in a child’s first days of life.
The appearance of spasm of fear is associated with a reaction to an unexpected shout, a flash of light. It has a reflex character. Accompanied by increased sweating, tachycardia, blood rush to the face, rapid breathing. Myoclonus of the middle ear is manifested by the appearance of ringing, clicking sounds.
Myoclonia physical activity is manifested after an intense workout, a long strain. In women, this type of contraction is associated with wearing high-heeled shoes. Typical examples are shin muscles. Occur also when smoking or regular drinking. In this case, there is a leaching of sodium and potassium from the muscles, a state provoking seizures develops.
Myoclonia is usually referred to as hiccups. It is associated with a response to irritation of two types of nerves – vagus and diaphragmatic, or parts of the brain stem. Manifested by a contraction of the diaphragm under the influence of intoxication, overeating.
A child up to one year old may develop myoclonia. It is manifested by spasms of the muscles of the head, body, hands, legs. Passes by itself.
The basis of this type of myoclonus is a certain pathology.
Epileptic – one of the symptoms of diseases associated with increased seizure activity. As the disease progresses, there is a progression of symptoms, contractions are becoming more frequent. Characterized by the breeding of hands to the side, possibly falling. Consciousness is safe, sometimes there is a feeling of stupidity.
Essential myoclonia develops on the basis of genetic predisposition. It is inherited and manifested at an early age. At the same time, an increase in symptoms is observed in adolescents.
Asterixis occurs when encephalopathy is associated with intoxication or metabolic disorders. The brush held on the weight suddenly drops, and then rises. A similar process occurs in the foot, muscle groups of other parts of the body.
According to the location of the lesion
In accordance with what part of the brain is affected, there are three types of myoclonia.
Cortical occurs when a convulsive discharge of the cerebral cortex. This form accompanies epileptic seizures. Usually leads to disability, poorly treatable.
Subcortical myoclonias result from an increase in the excitation processes of the brain that are associated with movements. This is the cerebellum, trunk motor centers, subcortical ganglia. Essential myoclonus is considered a frequent manifestation of this pathology.
Spinal appear in connection with the increased activity of the motor neurons of the spinal cord. Basically, the nerve cells of a particular department are activated.
Various lesions of the nerve roots, endings and plexuses cause peripheral myoclonia.
By the nature of muscle contraction
On the one hand, the peculiarities of convulsions allow us to distinguish a certain rhythm in them. If it is present, we are talking about rhythmic myoclonia, if not – about non-rhythmic.
On the other hand, the degree of muscle involvement is important. With focal myoclonus, twitching of one group of muscle fibers, for example, mimic, occurs.
Segmental is characterized by myoclonus of muscle groups located next to each other. Generalized is manifested by contractions of several fiber groups at once. Occurs mainly in injuries or inflammation of the spinal cord. Accompanied by a fall.
By type of stimulus
At times, contractions are caused by certain stimuli-stimuli, for example, sound, touch, low temperature. In this case, it is customary to speak of a reflex myoclonus.
Arbitrary motion cause kinetic contractions. Such is the nature of polyminoclonus. It manifests itself as spasms, in which it is impossible to register a rhythm, resembles a tremor. Often associated with localization in the muscles of the eyes. Their erratic movements are amplified as a person tries to fix his gaze on an object.
Spontaneous contractions appear for no apparent reason.
Single myoclonic spasms, as well as twitching, which occur several times a minute, are isolated.
It is customary to talk about asymmetric and symmetric twitching. The first appear differently on the left and right sides. The second is the same.
Benign myoclonus appears after a strong emotional or physiological stress.
Pathology arises due to the following reasons:
- spinal cord and brain injuries;
- vascular diseases;
- genetic disorders;
- liver dysfunction;
- kidney disease.
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The most important manifestation of myoclonia is a sharp, unexpectedly appearing contraction of muscle tissue, arising as from an electric shock. Twitching in sleep. The exception is Kozhevnikovskaya epilepsy.
Usually cuts last a few seconds. Spasms caused by hypoxia last for several hours. The intensity of contractions increases with emotional stress.
The main purpose of the diagnosis is to delimit myoclonus from other pathological conditions that have similar symptoms, such as tremor or motor cramps.
Measures to identify the disease and its causes include a mandatory account of the patient’s disturbing symptoms. If cramps occur in a child, they are described by parents. The exact picture of convulsions, their nature, time of appearance will help form a list of additional studies.
Usually they include:
- Electroencephalography. Used to register the bioelectric activity of the brain and diagnose the causes of convulsions.
- Electromyography. The method is aimed at determining the degree of excitability of muscles, the preservation of nerve tissue.
- X-ray Allows you to identify volume disorders in the brain: tumors, hematomas, vascular pathology.
- Magnetic resonance imaging or CT. Both methods give a clear picture of the nature, cause, extent of brain damage.
In the case of benign myoclonic contractions associated with overwork or fright, no special treatment is required. It may be necessary to take sedatives in some cases (valerian tincture, motherwort).
With frequent seizures, complex treatment is indicated, which includes the use of nootropic drugs aimed at improving metabolic processes in the central nervous system (Glycine, Pantogam, Nootropil).
The epileptic nature of myoclonus is an indication for the appointment of anticonvulsants, it is Carbamazepine.
In severe cases, hormonal drugs (corticosteroids), psychotropic drugs (Levomepromazine, Thioridazine, Frenolone), drugs of the benzodiezepine group are used. The action of the latter is aimed at relaxing the muscles, normalizing sleep, reducing seizures. This group includes Clonazepam, Diazepam, Loprazolam.
Measures to prevent the development of myoclonus include reducing situations associated with mental stress, maintaining a calm environment. Normal sleep in adults should last seven hours, in children – ten. To relax before bedtime, it is useful to take a warm bath.
An hour before bedtime, do not watch TV, do not sit at the computer. Better at this time to put scented candles and make a massage.
During the day, take walks in the fresh air, eat normally, do not smoke or take alcohol.
Cortical myoclonus (myoclonus) is often manifested as a natural reaction to overwork, unexpected stimuli. This form does not need to be treated. Negative cause various pathologies, such as epilepsy or encephalopathy. Her therapy and prognosis depends on the underlying disease. For the prevention of pathology, it is recommended to lead a healthy lifestyle.
The following sources were used to prepare the article:
Mironov M. B., Nogovitsin V. Yu., Abramov M. O., Dombrovskaya E. A., Kvaskova N. E., Mukhin K. Yu. Femzherman’s Syndrome (benign non-epileptic myoclonus of infancy) // Epilepsy and Paroxysmal States Journal – 2013.