Clinical Utility of Neurophysiologic Classification (and Declassification) of Myoclonus

Background Movement clinical neurophysiology studies can distinguish myoclonus, tremor, and other jerky movements; however, there has been limited demonstration of their real‐world clinical impact. Objective The aim was to investigate movement study utility in clarifying movement classification and...

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Published in:Movement disorders 2024-12, Vol.39 (12), p.2242-2248
Main Authors: Callister, Marcus N., Klanderman, Molly C., Stockard, Alyssa, Van Der Walt, Charles, Pena, Ashley B., Caviness, John N.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Classification
Diagnosis
Electroencephalography - methods
Electromyography - methods
Female
Humans
Male
Middle Aged
Movement disorders
Myoclonus
Myoclonus - classification
Myoclonus - diagnosis
Myoclonus - physiopathology
neurophysiology
Retrospective Studies
Tremor
Tremor - classification
Tremor - diagnosis
Tremor - physiopathology
Young Adult
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Summary:Background Movement clinical neurophysiology studies can distinguish myoclonus, tremor, and other jerky movements; however, there has been limited demonstration of their real‐world clinical impact. Objective The aim was to investigate movement study utility in clarifying movement classification and guiding patient management. Method A retrospective study of myoclonus‐related movement studies was performed. Results Of 262 patients referred for consideration of myoclonus, 105 (40%) had myoclonus, 156 (59%) had no myoclonus (the commonest alternative classifications were functional jerks and tremor), and 1 was uncertain. An additional 29 studies identified myoclonus without prior clinical suspicion. A total of 119 of 134 (89%) myoclonus patients had a specific neurophysiologic subtype identified, most commonly cortical (64, 54%). Diagnostic differential narrowed in 60% of patients, and a new diagnosis was made in 42 (14%) patients. Medication changes were made in 151 patients (52%), with improvement in 35 of 51 (67%) with follow‐up. Conclusions Movement studies effectively determined movement classification and identified unsuspected myoclonus, leading to changes in diagnosis and management. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
ISSN:0885-3185
1531-8257
1531-8257
DOI:10.1002/mds.30022