Tuesday, September 15, 2020

myoclonus treatment

 Q: Which of the following is preferred treatment for myoclonus? (select one)

A) Levetiracetam 

 B) Phenytoin

Answer: A

Although historically phenytoin has been used for cortical myoclonus but it can paradoxically exacerbate myoclonus. Special care should be taken on patients who have myoclonus with Unverricht-Lundborg disease, which is progressive myoclonic epilepsy disorder. Also phenytoin can make symptoms worse in palatal myoclonus and cortical-subcortical myoclonus. Levetiracetam is the preffered drug of choice. 

There is a long list of medications which have been tried with various successes including piracetam, brivaracetam, clonazepam, and valproic acid.




1. Lim LL, Ahmed A. Limited efficacy of levetiracetam on myoclonus of different etiologies. Parkinsonism Relat Disord 2005; 11:135.

2. Eldridge R, Iivanainen M, Stern R, et al. "Baltic" myoclonus epilepsy: hereditary disorder of childhood made worse by phenytoin. Lancet 1983; 2:838.

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