MSD Manual

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Alex Rajput

, MD, University of Saskatchewan;

Eric Noyes

, MD, University of Saskatchewan

Reviewed/Revised Feb 2024

Myoclonus refers to quick, lightning-like jerks (contractions) of a muscle or a group of muscles.

  • Myoclonus may occur normally (for example, jerking of a leg when a person is falling asleep), but it may result from a disorder, such as liver failure, a head injury, low blood sugar, or Parkinson disease or from use of certain medications.

  • Muscles may jerk quickly or slowly, and jerking may be rhythmic or not.

  • Doctors diagnose myoclonus based on symptoms and do blood tests, electromyography, and/or magnetic resonance imaging to identify the cause.

  • The cause of myoclonus is corrected if possible, but if the cause cannot be corrected, certain antiseizure medications or clonazepam (a mild sedative) may lessen symptoms.

Myoclonus may involve only one hand, a group of muscles in the upper arm or leg, or a group of facial muscles. Or it may involve many muscles at the same time.

Myoclonus may be classified in many different ways:

  • By cause: Whether it occurs normally, is caused by a disorder, medication, or substance or has no identifiable cause

  • By severity: How much of the brain is damaged or how severe the symptoms are

  • By location: Where the brain is damaged

  • By triggers: Whether it is triggered by a stimulus (such as bright light or a sudden noise) or occurs on its own (spontaneously)

Classifying the type of myoclonus may help doctors identify the cause and choose appropriate treatments.

Causes of Myoclonus

Myoclonus may occur normally, often when a person is falling asleep. For example, as people start to doze off, they may jerk suddenly and awaken (as if startled), or muscles in part of the body may twitch. Abnormal myoclonus tends to occur more randomly and/or be more severe or frequent.

However, in some cases myoclonus may result from a disorder, such as the following:

Myoclonus can occur after a person takes high doses of certain medications such as the following:

  • Antihistamines

  • Some antidepressants (such as amitriptyline)

  • Some antibiotics (such as penicillin and cephalosporins)

  • Bismuth

  • Levodopa (used for Parkinson disease)

  • Opioids

Symptoms of Myoclonus

Myoclonus can be mild or severe. Muscles may jerk quickly or slowly, rhythmically or not. Myoclonus may occur once in a while or frequently. It may occur spontaneously or be triggered by a stimulus, such as a sudden noise, light, or a movement. For example, reaching for an object or taking a step may trigger jerks that disrupt the movement.

If myoclonus is due to a metabolic disorder, the face, upper arms, and thighs are usually affected. If it persists, it may affect muscles throughout the body, sometimes leading to seizures.

Did You Know...

  • Some types of myoclonus—such as the quick twitches of muscles as a person falls asleep—are normal.

Diagnosis of Myoclonus

  • A doctor's evaluation

  • Blood tests and sometimes other tests to identify the cause

The diagnosis of myoclonus is based on symptoms.

Testing is usually done to identify the cause:

Treatment of Myoclonus

  • Correction of the cause if possible

  • Medications to lessen symptoms

The cause of myoclonus is corrected if possible. For example, medications that can cause myoclonus are stopped. A high or low blood sugar level is corrected, and kidney failure is treated with hemodialysis.

If the cause cannot be corrected, certain antiseizure medications (such as valproate and levetiracetam—see table ) or clonazepam (a mild sedative) may lessen symptoms. Choice of medication depends on where the brain is damaged. In some cases, a combination of medications is necessary.

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