neurologic disorders
Myoclonus
Treatment of Myoclonus
Correcting the metabolic disturbance or other cause if possible Stopping or reducing the dose of the causative drug Drug therapy to relieve symptoms Treatment of myoclonus begins with correction of underlying metabolic disturbances or other causes if correctable. If a drug is the cause, the drug is stopped, or the dose is reduced. For symptom relief,clonazepam0.5 to 2 mg orally 3 times a day is often effective. Valproate 250 to 500 mg orally 2 times a day orlevetiracetam250 to 500 mg orally 1 or 2 times a day may be effective; rarely, other antiseizure drugs help. Doses ofclonazepamor valproate may need to be lower in older patients. Site of origin for myoclonus can help guide treatment. For example, valproate,levetiracetam, and piracetam tend to be effective in cortical myoclonus but ineffective in other types of myoclonus.Clonazepammay be effective in all types of myoclonus. In some cases, a combination of drugs is necessary. In the past, many types of myoclonus seemed to respond to the serotonin precursor 5-hydroxytryptophan, which was used with the oral decarboxylase inhibitorcarbidopa, but 5-hydroxytryptophan is not used anymore because better drugs are now available. 