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What Causes Myoclonus Post DBS Surgery For Dystonia?

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Posted on Sat, 17 Sep 2016
Question: I developed myoclonus after DBS surgery for dystonia 18 months ago. Initially it was just an over exaggerated startle response. Despite increasing doses of clonazepram it has continued progressing and friends are now expressing comments at just how violent the full body spasms have become. I regularly fall backwards during episodes hitting myself on furniture Etc and have frequently come close to falling backwards headfirst down the stairs. During episodes I now dribble and can make vocal sounds. If on a chair it tips backwards and I have been jerked out of an armchair and bed. Whilst holding onto a 21lb weight walker with the brakes on it just tips over with me. Recently friends have commented they witnessed prior to the jerking I appeared vacant, then my eyes rolled back in my head and I went stiff none of which I was aware of. One friend stated its looked identical to what she witnesses when her niece who has epilepsy. Prior to the op the surgeon warned me some people can be left with seizures afterwards which can be controlled with drugs. My question is are the symptoms my friends witnessed normal for myoclonus or could I be having seizures. I am currently on 1mg clonazepram twice a day which has not helped. I am having high number of falls up to thirty a month which I find scary and is starting to affect my confidence in going out alone. As well as the jerking episodes my dystonia causes me falls too due to motor control problems with my legs. I am ashamed to admit I am struggling with fear of falling so reluctant to ask for help but it is starting to get me down.
XXXXX
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Answered by Dr. Dr. Erion Spaho (24 minutes later)
Brief Answer:
Seizures most likely.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

Regarding to symptoms you describe, in my opinion seizures is the most probable condition.

Seizures or jerking attacks after deep brain stimulation may be related to lead misplacement issues.

Also the pathway through the brain tissue may induce seizures too.

It is necessary to get evaluated with a MRI and careful measurement of the leads and electroencephalogram (EEG) in order to understand better your condition.

If seizures confirmed, antiepileptic drugs (carbamazepine, valproate, levetiracetam etc.) should be used.

Discuss with your treating Doctor about these issues.

Hope you found the answer helpful.

Let me know if I can assist you further.

Greetings.


Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
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Answered by
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Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4493 Questions

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What Causes Myoclonus Post DBS Surgery For Dystonia?

Brief Answer: Seizures most likely. Detailed Answer: Hello and thanks for using HCM. I have read your question and understand your concerns. Regarding to symptoms you describe, in my opinion seizures is the most probable condition. Seizures or jerking attacks after deep brain stimulation may be related to lead misplacement issues. Also the pathway through the brain tissue may induce seizures too. It is necessary to get evaluated with a MRI and careful measurement of the leads and electroencephalogram (EEG) in order to understand better your condition. If seizures confirmed, antiepileptic drugs (carbamazepine, valproate, levetiracetam etc.) should be used. Discuss with your treating Doctor about these issues. Hope you found the answer helpful. Let me know if I can assist you further. Greetings.