Question:
I'm a
34 year old female who has had and still got a tremendous amount of
stress in every aspect of my life.
I have
been diagnosed with depression and am currently on chronic medication.
I get
very funny episodes of attacks whereby either my left or right side
(leg or arm) starts twitching which is very painful so much so that
I'm not able to touch the area.
I've
seen various experts but none of them were able to tell me what is
wrong with me.
I'm
really worried because this is occurring more frequently.
PLEASE
HELP!!!!!!!!
Willianne
Answer:
Dear
Willianne,
Myoclonus
is a brief, involuntary twitching of a muscle or a group of muscles.
It describes
a medical sign and, generally, is not a diagnosis of a disease.
Myoclonic
jerks may occur alone or in sequence, in a pattern or without pattern.
Muscle
jerks occur as a result of a medication reaction among other causes.
Treatment
of myoclonus is most effective when a reversible underlying cause
can be found - such as a medication or toxin that can be discontinued
or "flushed out" of your body.
Medications
that doctors commonly prescribe for myoclonus include:
* Tranquilizers.
Clonazepam (Klonopin) is the most common drug used to combat myoclonus
symptoms.
* Anticonvulsants. Drugs used to control epileptic seizures have also
proved helpful in reducing myoclonus symptoms. The most common anticonvulsants
used for myoclonus are levetiracetam (Keppra), valproic acid (Depakene)
and primidone (Mysoline).
Botulinum
toxin type A (Botox) injections may be helpful in treating various
forms of myoclonus, particularly if only a single area is affected.
Botulinum toxins block the release of a chemical messenger that triggers
muscle contractions.
Guen
A and Moret Chalmin C. from the Service de Neurologie, Hôpitaux
de Paris, Chaville, described a particular case of major depression
with diffused myoclonus, occuring in the same time, with an uncommon
area which is the soft palate and stapedius muscle. The successful
treatment was with serotonin reuptake inhibitors.
Kevin
John Blacka and Naei Kilzieha from the Department of Psychiatry, Washington
University School of Medicine, St Louis, Missouri, published in the
journal Annals of Clinical Psychiatry, Volume 6, Issue 1 March 1994
, pages 45 - 49 , that mild myoclonus is reasonably common with various
cyclic antidepressants.
However,
antidepressants rarely cause severe myoclonus, and no risk or predisposing
factors have been reported in the literature.
They
reported a case of exceptionally severe myoclonus developing at therapeutic
doses and modest serum levels of imipramine.
They
suggested that the onset of one movement disorder after drug therapy
(eg, myoclonus) may predict the development of other movement disorders
(e.g., catatonia).
