Management of patients with myoclonus: available therapies and the need for an evidence-based approach.
Myoclonus is a hyperkinetic movement disorder characterised by quick and involuntary jerks. Therapy should focus on cure of an underlying disorder; however, symptomatic treatment is often needed when treatment of an underlying cause is impossible or ineffective. The appropriate treatment for a specific type of myoclonus is based on the classification of the anatomical origin of the myoclonus: cortical, subcortical, spinal, or peripheral. We outline criteria for classification and present an overview of the available therapeutic options for the different types of myoclonus. Because of a generally low level of evidence, therapeutic options mainly rely on small observational studies and expert opinion. For an evidence-based approach in the future, randomised controlled trials of symptomatic therapies for myoclonus in homogeneous patient groups are needed.
Dijk
Joke M
JM
Department of Neurology, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands. m.a.tijssen@amc.uva.nl
Tijssen
Marina A J
MA
D000818:Animals; D019468:Disease Management; D019317:Evidence-Based Medicine / Q000379:methods* / Q000639:trends; D006801:Humans; D009207:Myoclonus / Q000145:classification / Q000175:diagnosis* / Q000628:therapy*