By: Natalie L. Boehm, MBA, RBLP-T

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What is epilepsy?

Epilepsy is a neurological disorder of the brain. Also referred to as a seizure disorder, individuals are diagnosed with epilepsy when they have two or more unprovoked seizures. Seizures are a result of abnormal brain activity, which can affect one or both sides of the brain. Depending on the type of seizure a person is having will affect how the body reacts, the person’s behavior and/or reactions, and if they remain or lose consciousness.

What are myoclonic seizures?

Myoclonic seizures cause brief, jerking spasms of a muscle or muscle group (Johns Hopkins, 2021). During a myoclonic seizure, most of the time a person is awake and aware of their environment. People with myoclonic epilepsy can go into status epilepticus when seizure activity exceeds thirty minutes and remain partially aware of their environment (ILAE, 2020).  Individuals with Lennox-Gastaut Syndrome and Infantile Spasms commonly have myoclonic seizures.

Causes of myoclonic seizures

Myoclonic seizures can develop for several reasons. In most situations, doctors are not able to find the exact cause of why someone is having myoclonic seizures. Unusual brain development, stroke, traumatic brain injury, brain tumors, meningitis, encephalitis, and oxygen deprivation to the brain can result in someone developing myoclonic seizures.

Symptoms associated with myoclonic seizures

Myoclonic seizures primarily affect the upper part of the body. Common symptoms that occur while a seizure is taking place are quick, uncontrolled movements, jerky or rhythmic movement, and unusual clumsiness (Cedars-Sinai, 2021). Sleep deprivation, excess alcohol intake, missing doses of anti-seizure meds, and stress are just a few of the many things that result in someone having a myoclonic seizure.

Syndromes associated with myoclonic seizures

Along with Lennox-Gastaut and infantile spasms, juvenile myoclonic epilepsy, progressive myoclonic epilepsy, and Dravet syndrome are common syndromes associated with myoclonic seizures. In most situations, the conditions can be monitored and controlled. Progressive myoclonic epilepsy is diagnosed by a physician when despite treatment, the patients condition gets progressively worse and seizures cannot be controlled.

Treatment with myoclonic seizures

Anti-seizure medication such as sodium valproate, levetiracetam, and lamotrigine are commonly prescribed to treat myoclonic seizures. Medications such as topiramate and zonisamide can be used as an add on if the first three do not work or cannot control the seizures completely. In situations where the person develops drug-resistant epilepsy a vagus nerve stimulator may be implanted to control seizure activity. In some drug-resistant cases, deep brain stimulation is being used as treatment to control seizure activity. 

First aid for myoclonic seizures

When someone has a myoclonic seizure, they are alert and aware of their surroundings. Speak calmly and if they are walking, guide them gently to a safe place. Stay with the person until the seizure has ended and they are able to respond normally (Cleveland Clinic, 2015). It is important to remember that when it comes to seizure first aid, it is not one size fits all. It is important to understand that depending on what type of seizure someone is having; you may have to react to the situation differently.

Conclusion

Myoclonic seizures cause brief, jerking spasms of a muscle or a group of muscles. Myoclonic seizures can develop for several reasons, but most of their time, a direct cause is not found. Myoclonic seizures primarily affect the upper part of the body and are common with many different epilepsy syndromes. Understanding seizure first aid for myoclonic seizures is essential to prevent injury of the person who is experiencing the seizure and to call for help if further action is needed.

Resources:

Cedars-Sinai (2021). Myoclonic Epilepsy. Cedars-Sinai. Retrieved from: https://www.cedars-sinai.org/health-library/diseases-and-conditions/m/myoclonic-epilepsy.html

Centers for Disease Control and Prevention (2020). Frequently Asked Questions About Epilepsy. Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/epilepsy/about/faq.htm

Cleveland Clinic (2015). Seizures: First Aid. Cleveland Clinic. Retrieved from: https://my.clevelandclinic.org/health/articles/6998-seizures-first-aid#:~:text=Myoclonic%20Seizures%20(Loss%20of%20Awareness,respond%20normally%20when%20spoken%20to.

International League Against Epilepsy (2020). Myoclonic Seizure. International League Against Epilepsy. Retrieved from: https://www.epilepsydiagnosis.org/seizure/myoclonic-overview.html

Johns Hopkins Medicine (2021). Myoclonic Seizures. Johns Hopkins Medicine. Retrieved from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/epilepsy/myoclonic-seizures

Mantoan, L., & Walker, M. (2011). Treatment options in Juvenile myoclonic epilepsy. Current treatment options in neurology, 13(4), 355-370. https://doi.org/10.1007/s11940-011-0131-z