Pediatric Movement Disorders - Myoclonus

Treatment

If a specific cause can be found, then the myoclonus will usually resolve if treatment of the underlying disease is effective. Immune-mediated myoclonus (such as occurs in opsoclonus-myoclonus) usually requires treatment with oral steroids such as prednisone, in addition to removal of the tumor if one is found.

Intravenous immunoglobulin and plasmapheresis has also been attempted in some cases. Juvenile myoclonus epilepsy usually responds to valproate, and may require life-long treatment. Symptomatic treatment usually includes benzodiazepines such as clonazepam or diazepam. Cortical myoclonus may respond to valproate, piracetam, or lamotrigine. There are reports of myoclonus due to a hypoxic event responding to 5-hydroxy-tryptophan (5HT), and this may be helpful in other causes as well. Carbamazepine may worsen myoclonus and should be avoided.