Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Myoclonic Jerks?
Question: I am a 49 year old white male with a family history of ALS and PICKS disease. My grandfather died from ALS in 1963 and father died 4 years ago after a 7 years slow death. As a child I had my share of head injuries and one did take me to the hospital that happened at school. But the worst was at home and my brother was too scared to tell anyone. I was hit flush in the forehead by a large log flying threw the air after being chopped with an axe knocking me out cold. Since those head injuries I have experienced myoclonic jerks off and on. I have other medical issues such as ulcerative colitis and psoriatic arthritis with spondylosis in my spine and neck. I also had a major pancreatic surgery 6 years ago for a tumor. About 6 years ago I developed a double pause beat with my heart that sometimes went into tach for a short period. EKG tests only showed 2 small murmurs but had low potassium from my colitis. Shortly after I started getting strange vertigo type attacks. I tried to explain them to doctor as a shock wave flowing from the sides of my head into my whole head. Very much like a numb feeling. Very hard to explain. In the last 2 years my myoclonic jerks increased. I would get a full body surge like being shocked. I would even make a hick up sound. Then about 4 months ago the myoclonic jerks turned into something else when I tried to sleep. I would get a lifting feeling in my gut that spread into my chest. Then suddenly I couldn't hear a sound as I felt a strong but slow motion electrical type shock in my whole body. I started having these multiple times a night to the point I could not sleep. My primary doctor thought these might be panick attacks but I explained I had no emotional hits with these attacks. I talked with a psychiatrist who also did not feel I was having panic attacks even though I was fighting emotions over failed health from my PA and colitis. My doctor put me on klonopin which has helped. I may not fall asleep faster but when I do sleep I sleep for 8 hours. I contacted a neurologist i first saw for the head vertigo issues 2 years prior. All I can say is that this doctor is a jerk to put it less insulting. When I first saw him it was after my primary found out about my fathers death. He had a ct done of my head and I hand carried it to the neurologist at Vanderbilt. He did a quick look while I watched and threw it in the trash then said nothing was wrong with me without even looking at me. I was sent back to this same doctor after being put on klonopin with a request from my primary some type of EEG study should be done and further tests ran. This made the neurologist even madder and my next visit he chose to chew me out because my primary put me on klonopin and asked for an EEG. Instead I was sent for a sleep study. The doctor there after going over my symptoms said I needed an EEG study first. I was given a 2 hour sleep deprived study. Results were nothing. Even though I knew I had 2 myoclonic jerks during the study and even the tech doing the study asked me why I did hit the panic button, nothing was found. Now again the neurologist doesn't want to see me for another year. I am lost at what to do. Years ago I worked in orthopedics. I am not an expert by any means but I have heard of neck arthritis causing head issues. I also question how this neurologist can clear me of anything my grandfather or father died from without doing further studies like a head and neck MRI. I live in east central TN. I have lost my job over medical issues and don;t have insurance at the moment. I have had to pay for everything out of savings which are now gone. Maybe soon If I win my disability case I may get some insurance from Tn under the TNCARE plan. But who should I seek out. Another neurologist or a spine doctor? I can honestly say I have auras at times during the day. My mother says i blank out often and she sees me jerking often. None of these do I have any memory of. I also have migraines daily and use imitrex.
Brief Answer:
Unlikely to be a seizure....
Detailed Answer:
Hi,
As your query was lengthy I went through it diligently for more than once. And all the times, I felt the symptoms closely matched myoclonic jerks. But then you finally had the EEG test which ruled this possibility out.
Myoclonic jerks are benign and harmless jerks restricted to children. Rarely when it present in adults, I refer my patients to rule out even rare medical conditions. Though you would have had the diagnosis with the EEG (had it been abnormal), I am extremely glad it came out normal ruling out myoclonic seizures.
In this context, I would suggest that you get back to the psychiatrist. Somatoform disorder is the next possibility that I thought of. This is a condition where symptoms closely match an organic condition, but investigations and evaluation don't explain them. I am not sure if this condition will help you get the disability care which you been looking for. But I think a second visit to the psychiatrist should sort the problem out.
Regards
Unlikely to be a seizure....
Detailed Answer:
Hi,
As your query was lengthy I went through it diligently for more than once. And all the times, I felt the symptoms closely matched myoclonic jerks. But then you finally had the EEG test which ruled this possibility out.
Myoclonic jerks are benign and harmless jerks restricted to children. Rarely when it present in adults, I refer my patients to rule out even rare medical conditions. Though you would have had the diagnosis with the EEG (had it been abnormal), I am extremely glad it came out normal ruling out myoclonic seizures.
In this context, I would suggest that you get back to the psychiatrist. Somatoform disorder is the next possibility that I thought of. This is a condition where symptoms closely match an organic condition, but investigations and evaluation don't explain them. I am not sure if this condition will help you get the disability care which you been looking for. But I think a second visit to the psychiatrist should sort the problem out.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I do not feel your answer is correct. All my medical issues have been verified threw tests and with specialist. My ulcerative colitis is real. My psoriatic arthritis is real. The damage in my neck is on x ray and verified. I did do one miss type during my first question with history. During my EEG the tech said he recorded 2 myoclonic jerks and asked me why I hadn't pressed the panic button to further mark these during the test. I worked in orthopedics years ago and know that RA in the neck can cause head issues. Like I wrote I had seen a psychiatrist who ruled out me having mental issues other than depression which I know I fight. I do have auras at times. I know of many who have gone threw sleep deprived tests that showed nothing only to have a grand mal days later. I strongly feel this neuroscience doctor is trying to get rid of me due to lack of insurance. If it wasn't for the sleep doctor requesting the EEG it wouldn't have been done. Even the staff at vanderbilt suggested I seek a second opinion due to how this doctor treated me. My main question is who do a see? Another neurologist or an orthopedic spine specialist?
.
I do not feel your answer is correct. All my medical issues have been verified threw tests and with specialist. My ulcerative colitis is real. My psoriatic arthritis is real. The damage in my neck is on x ray and verified. I did do one miss type during my first question with history. During my EEG the tech said he recorded 2 myoclonic jerks and asked me why I hadn't pressed the panic button to further mark these during the test. I worked in orthopedics years ago and know that RA in the neck can cause head issues. Like I wrote I had seen a psychiatrist who ruled out me having mental issues other than depression which I know I fight. I do have auras at times. I know of many who have gone threw sleep deprived tests that showed nothing only to have a grand mal days later. I strongly feel this neuroscience doctor is trying to get rid of me due to lack of insurance. If it wasn't for the sleep doctor requesting the EEG it wouldn't have been done. Even the staff at vanderbilt suggested I seek a second opinion due to how this doctor treated me. My main question is who do a see? Another neurologist or an orthopedic spine specialist?
.
I do not feel your answer is correct. All my medical issues have been verified threw tests and with specialist. My ulcerative colitis is real. My psoriatic arthritis is real. The damage in my neck is on x ray and verified. I did do one miss type during my first question with history. During my EEG the tech said he recorded 2 myoclonic jerks and asked me why I hadn't pressed the panic button to further mark these during the test. I worked in orthopedics years ago and know that RA in the neck can cause head issues. Like I wrote I had seen a psychiatrist who ruled out me having mental issues other than depression which I know I fight. I do have auras at times. I know of many who have gone threw sleep deprived tests that showed nothing only to have a grand mal days later. I strongly feel this neuroscience doctor is trying to get rid of me due to lack of insurance. If it wasn't for the sleep doctor requesting the EEG it wouldn't have been done. Even the staff at vanderbilt suggested I seek a second opinion due to how this doctor treated me. My main question is who do a see? Another neurologist or an orthopedic spine specialist?
Brief Answer:
Neurologist is preferred over orthopedic ..
Detailed Answer:
I take your feed backs positively. Perhaps, I did not present my opinion in the right way. So let me start the discussion afresh.
Seizure is a condition diagnosed based on history. And as you mentioned, few people who had been labelled normal on EEG went on to have grand mal - that's absolutely true. However if there was a live seizure like activity witnessed during the recording and there was no seizure activity recorded in the graph, the diagnosis of epilepsy is doubtful. You can visit another neurologist / epileptologist with this EEG record for a second opinion. During the consultation, please ask the doctor if they found any epileptic discharges.
I did not mean to say that psoriatic arthritis, ulcerative colitis or the pancreatic tumour are false. But the diagnosis of myoclonic seizure is doubtful if the EEG record didn't have epileptoform discharges though you experienced seizure like activity during the recording. The procedure can be repeated if needed by a second neurologist.
As far as orthopedic surgeon is concerned, myoclonic jerks is not an orthopedician's expertise.
I understand symptoms very closely match myoclonic seizure. But the EEG recording will be a tool either to confirm the diagnosis or rule it out. A neurologist or an epileptologist will be the right specialist to approach and not spine surgeon.
Neurologist is preferred over orthopedic ..
Detailed Answer:
I take your feed backs positively. Perhaps, I did not present my opinion in the right way. So let me start the discussion afresh.
Seizure is a condition diagnosed based on history. And as you mentioned, few people who had been labelled normal on EEG went on to have grand mal - that's absolutely true. However if there was a live seizure like activity witnessed during the recording and there was no seizure activity recorded in the graph, the diagnosis of epilepsy is doubtful. You can visit another neurologist / epileptologist with this EEG record for a second opinion. During the consultation, please ask the doctor if they found any epileptic discharges.
I did not mean to say that psoriatic arthritis, ulcerative colitis or the pancreatic tumour are false. But the diagnosis of myoclonic seizure is doubtful if the EEG record didn't have epileptoform discharges though you experienced seizure like activity during the recording. The procedure can be repeated if needed by a second neurologist.
As far as orthopedic surgeon is concerned, myoclonic jerks is not an orthopedician's expertise.
I understand symptoms very closely match myoclonic seizure. But the EEG recording will be a tool either to confirm the diagnosis or rule it out. A neurologist or an epileptologist will be the right specialist to approach and not spine surgeon.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
