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The Neurophysiological Basis of Myoclonus 

The Neurophysiological Basis of Myoclonus
Chapter:
The Neurophysiological Basis of Myoclonus
Author(s):

Phillip D. Thompson

, Hiroshi Shibasaki

, and Mark Hallett

DOI:
10.1093/med/9780190228484.003.0037
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date: 16 October 2019

There are several types of myoclonus, with a variety of classification schemes, and the clinician must determine what type of myoclonus a patient has and what type of neurophysiological assessment can facilitate diagnosis. The electromyographic (EMG) correlate of the myoclonus should be examined, including the response to sensory stimuli (C-reflex). The electroencephalographic (EEG) correlate of the myoclonus should then be examined, possibly including back-averaging from the myoclonus or looking at corticomuscular (EEG–EMG) coherence. The somatosensory evoked response (SEP) should be obtained. Such studies will help determine the myoclonus origin, most commonly cortical or brainstem. One form of cortical myoclonus has the clinical appearance of a tremor (cortical tremor). Brainstem myoclonus includes exaggerated startle (hyperekplexia). Other forms of myoclonus include spinal myoclonus and functional myoclonus, which have their own distinct physiological signature. Several causes of myoclonus are reviewed, including rare types such as Creutzfeldt-Jakob disease and subacute sclerosing panencephalitis.

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