STUDY - Technical - New Dacian's Medicine
Myoclonus
(Classical / Allopathic Medicine)
Myoclonus -
sudden, shocklike contractions of a single muscle or muscle
group - can occur as a result of various neurologic disorders
and commonly heralds the onset of a seizure. These
contractions may be isolated or repetitive, rhythmic or
arrhythmic, symmetrical or asymmetrical, synchronous or
asynchronous, and generalized or focal. They may be
precipitated by bright flickering lights, a loud sound, or
unexpected physical contact. One type, intention myoclonus, is
evoked by intentional muscle movement.
Myoclonus occurs
normally just before falling asleep and as a part of the
natural startle reaction. It also occurs with some poisonings
and, rarely, as a complication of hemodialysis.
ALERT:
If you observe myoclonus:
- check for seizure activity
- take the patient's vital signs
- evaluate respiratory function
- institute emergency measures, if necessary.
If the patient's condition permits, perform a focused assessment.
If you observe myoclonus:
- check for seizure activity
- take the patient's vital signs
- evaluate respiratory function
- institute emergency measures, if necessary.
If the patient's condition permits, perform a focused assessment.
HISTORY:
Ask the patient about the frequency, severity, location, and circumstances of the myoclonus.
Ask the patient if he has ever had a seizure. If so, ask him whether myoclonus preceded it. Is the myoclonus ever precipitated by a sensory stimulus?
Review the patient's medical history.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Ask the patient about the frequency, severity, location, and circumstances of the myoclonus.
Ask the patient if he has ever had a seizure. If so, ask him whether myoclonus preceded it. Is the myoclonus ever precipitated by a sensory stimulus?
Review the patient's medical history.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
PHYSICAL
ASSESSMENT:
Evaluate the patient's level of consciousness and mental status.
Perform a complete neurologic assessment.
Check for muscle rigidity and wasting, and test deep tendon reflexes.
Evaluate the patient's level of consciousness and mental status.
Perform a complete neurologic assessment.
Check for muscle rigidity and wasting, and test deep tendon reflexes.
SPECIAL
CONSIDERATIONS:
If the patient's myoclonus is progressive, institute seizure precautions.
If the patient's myoclonus is progressive, institute seizure precautions.
PEDIATRIC
POINTERS:
Although myoclonus is relatively uncommon in infants and children, it can result from subacute sclerosing panencephalitis, severe meningitis, progressive poliodystrophy, childhood myoclonic epilepsy, or encephalopathy such as Reye's syndrome.
Although myoclonus is relatively uncommon in infants and children, it can result from subacute sclerosing panencephalitis, severe meningitis, progressive poliodystrophy, childhood myoclonic epilepsy, or encephalopathy such as Reye's syndrome.
PATIENT
COUNSELING:
Instruct the patient and his family about the need for safety precautions. Advise them to remove potentially harmful objects from the patient's environment.
Instruct the patient and his family about the need for safety precautions. Advise them to remove potentially harmful objects from the patient's environment.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common symptoms,
Edition V, McGraw - Hill, 2002.