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Friday, December 6, 2013
Jerks, Twitches, Myoclonus?
After a status a year ago I started to have jerks & twitches. When drugs were added (Pheno) & the prior ones were upped the jerks began. The Pheno. has been gone for some time & I am back to the levels of the drugs I had before the status, but the jerks remain. I`m on Lamictal & Keppta, both are supposed to control myoclonic, but obviously not mine. Any advice on a drug for myoclonic?
Keppra (levetiracetam) is approved for myoclonus, and generally works pretty well. Lamictal (lamotrigine) works for generalized epilepsy, but is not particularly effective against myoclonus.
The first step is always to record the jerks and twitches on video/EEG to be sure it is myoclonus one is treating.
Once the diagnosis is established as myoclonus, then Depakote (valproate) is another medication that can be effective.
Sometime Topamax (topiramate) can work in myoclonus.
It is not clear yet if the two newest drugs, Vimpat (lacosamide) and Banzel (rufinamide) are effective for myoclonus.
Michael Privitera, MD
Professor of Neurology
College of Medicine
University of Cincinnati