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What are myoclonus and tics, and what causes them?

Myoclonus refers to a sudden twitching or jerking of a muscle or a group of muscles. These movements are caused by sudden muscle contraction when resting (positive myoclonus) or by sudden relaxation whilst they are being used (negative myoclonus).

Myoclonus can occur at any age and some types are perfectly normal, such as hiccups or twitches before sleep. Other types might interfere with the ability to move or talk, and can be caused by underlying infection, medication side effects, or brain or spinal cord injury. In some cases, it can be part of a medical condition affecting the nervous system, such as Parkinson’s disease or multiple sclerosis.

Tics are repetitive jerky motions that can begin in childhood and usually improve with age. They begin with an unpleasant urge to perform a certain movement, and this urge is relieved by the tic.

The exact cause of tics is not known, but it is thought to be related to a problem in areas of the brain that control movement, such as the basal ganglia. Tics can also occur as part of a condition known as Tourette’s syndrome (a nerve disorder that causes a person to make involuntary movements and sounds).

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What are the symptoms of myoclonus and tics?

Myoclonus

Myoclonus can occur regularly and seem co-ordinated, or be completely irregular. There are several types of myoclonus that are each named according to the pattern of symptoms they show:

Action myoclonus is when the sudden twitching of muscles is triggered as the person moves, or even tries to move. It often affects the arms, legs, face and speech.

Myoclonus dystonia is seen when the movements of myoclonus occur alongside twisting and painful muscle contractions that cause abnormal postures (dystonia).

Palatal myoclonus involves the muscles at the back of the roof of the mouth and can affect speech. The muscle contractions are usually rapid and can also occur during sleep.

Myoclonic seizures are caused when myoclonus occurs in a person who suffers from epilepsy (a condition where the electrical activity in the brain becomes disturbed). This usually affects both sides of the body at the same time.

Tics

Tics differ from myoclonus as they can sometimes be suppressed. They are classified as either simple or complex:

Simple tics are brief and sudden, typically lasting for less than a second, and only involving a few muscle groups. Examples of simple tics include blinking, grimacing, shrugging your shoulders, sniffing and coughing.

Complex tics involve more muscle groups that produce a co-ordinated movement or noise. They can appear purposeful, for example, bending or twisting, repeatedly touching an object, or uttering offensive words.

How are myoclonus and tics diagnosed?

Our team of leading specialist doctors here at The London Clinic Centre for Movement Disorders are on hand to help identify and manage a whole range of conditions including myoclonus and tics.

They will begin by asking some questions about the symptoms and general health of the patient. Information about any medications that are being taking is also important.

The diagnosis is mostly based on this clinical information as well as a careful physical assessment. Blood tests, MRI scans of the brain, and an EEG (electroencephalogram), which measures electrical activity in the brain, may also be used to help diagnosis.

What are the common treatments for myoclonus and tics?

Our team of leading specialist doctors here at The London Clinic Centre for Movement Disorders are on hand to help identify and manage a whole range of conditions including myoclonus and tics.

Myoclonus

If an underlying problem is found to be the cause, then myoclonus treatment will be focused on managing that effectively. If there is no obvious cause, treatment will be aimed at controlling the symptoms.

Medications are usually the first treatment option. Minor sedatives and anti-epilepsy medicines are often successful at reducing myoclonus. A combination of different medications may be needed to provide effective relief and it may take time to find the correct doses.

Botulinum toxin (Botox) injections can be used to insert a small amount of chemical toxin directly to the spasming muscles to help them relax. Results can be seen within a few days and can temporarily improve symptoms. It is not a permanent solution, but the effects will normally last for several months.

Tics

Tics may resolve on their own, or if symptoms are mild they may not need any treatment. If they are problematic, then there are some measures that can be taken to provide some relief:

Lifestyle changes can help with symptom control. Reducing stress, anxiety, and getting enough sleep can all help to reduce the severity of tics.

Behavioural therapy can help to raise awareness of the tic and teach new ways to respond to the urge through structured distractions.

Medications such as antipsychotics can be used to reduce the levels of certain brain signalling chemicals (neurotransmitters) that are responsible for tics. Minor sedatives can also help to ease symptoms, or Botox injections can be used to relax the muscles involved in the tic.

Surgical procedures such as deep brain stimulation are used to provide relief in some severe cases of Tourette’s syndrome. This involves inserting tiny wires called electrodes into the regions of the brain responsible for the tic. The electrodes are connected to a small electrical device that sits under the skin - this delivers a painless electrical impulse to block the signals causing the tic.

Why choose The London Clinic?

At The London Clinic, we understand that each of our patients is unique and strive to offer a personalised experience with an excellent quality of care. We are committed to providing fast access to the latest diagnostic technology and innovative treatments. At our state-of-the-art facilities, we offer access to a full multidisciplinary team with expert specialists and clinical support teams that are second to none.

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