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Electrophysiologic testing aids diagnosis and subtyping of myoclonus

Zutt, Rodi, Elting, Jan W., van Zijl, Jonathan C., van der Hoeven, J. Han, Roosendaal, Christiaan M., Gelauff, Jeannette M., Peall, Kathryn J. and Tijssen, Marina A. J. 2018. Electrophysiologic testing aids diagnosis and subtyping of myoclonus. Neurology 90 (8) , e647-e657. 10.1212/WNL.0000000000004996

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Abstract

Objective To determine the contribution of electrophysiologic testing in the diagnosis and anatomical classification of myoclonus. Methods Participants with a clinical diagnosis of myoclonus were prospectively recruited, each undergoing a videotaped clinical examination and battery of electrophysiologic tests. The diagnosis of myoclonus and its subtype was reviewed after 6 months in the context of the electrophysiologic findings and specialist review of the videotaped clinical examination. Results Seventy-two patients with myoclonus were recruited. Initial clinical anatomical classification included 25 patients with cortical myoclonus, 7 with subcortical myoclonus, 2 with spinal myoclonus, and 15 with functional myoclonic jerks. In 23 cases, clinical anatomical classification was not possible because of the complexity of the movement disorder. Electrophysiologic testing was completed in 66, with agreement of myoclonus in 60 (91%) and its subtype in 28 (47%) cases. Subsequent clinical review by a movement disorder specialist agreed with the electrophysiologic findings in 52 of 60; in the remaining 8, electrophysiologic testing was inconclusive. Conclusions Electrophysiologic testing is an important additional tool in the diagnosis and anatomical classification of myoclonus, also aiding in decision-making regarding therapeutic management. Further development of testing criteria is necessary to optimize its use in clinical practice.

Item Type: Article
Date Type: Published Online
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Neuroscience and Mental Health Research Institute (NMHRI)
Subjects: R Medicine > R Medicine (General)
Publisher: American Academy of Neurology
ISSN: 0028-3878
Funders: Medical Research Council
Date of First Compliant Deposit: 25 January 2018
Date of Acceptance: 20 November 2017
Last Modified: 13 Feb 2019 15:40
URI: http://orca.cf.ac.uk/id/eprint/108480

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