Cirrhosis Support Group

debi5200, I asked this same question about a week ago, didn't know there was an actual name for it ! chucks has gotten so bad that there are nights that I have to sleep in another bed just to get some rest. It doesn't keep him awake and he doesn't even realize he is doing it.

Welcome, I have only been a member for a few short weeks and already have more information than any dr would ever share. this sight has also attributed to chuck feeling a lot better cause of me reading about him staying away from beef. it has made a huge improvement for him.

Yes. Is it also accompanied by a very dull insidious ache in the legs and possibly the arms. Does he thrash in his sleep or have difficulty staying asleep? Does it go away when he gets up and walks around?
If so, I suggest you take a look at the RLS board. Restless Leg Syndrome.

Yes he stays awake for hours on end almost nightly, mainly we attribute this to the complications of his hepatic encephalopathy. When he's asleep he is not aware that his body is jumping.

His ammonia levels have been high also, and it doesn't seem to make any real difference if his levels are 90 or 159, he still feels very light headed and stumbles often.

He hasn't had any red meat in almost six months, and is only allowed limited amounts of fish, chicken, and turkey.

Thanks for responding.

This is what the Mayo Clinic has to say about it:

Definition
By Mayo Clinic staff
Myoclonus refers to a quick, involuntary muscle jerk. For example, hiccups are a form of myoclonus. So are the sudden jerks, or "sleep starts," you may experience just before falling asleep. These forms of myoclonus occur in healthy people and rarely present a problem.

More severe types of myoclonus can be triggered by an underlying medical condition, such as a head injury or a reaction to a medication.

For effective treatment, you need to discover what's causing your myoclonus symptoms. If the cause of your myoclonus is chronic or unexplained, then treatment focuses on reducing the effects of myoclonus on your quality of life.

Symptoms
By Mayo Clinic staff
The muscle jerks associated with myoclonus are:

Sudden
Involuntary
Shock-like
Variable in intensity and frequency
Often limited to one muscle, or initially limited to a group of muscles before spreading to other areas
Sometimes severe enough to interfere with eating, talking or walking

When to see a doctor
If your myoclonus symptoms become frequent and persistent, talk to your doctor for further evaluation and proper diagnosis and treatment.

Causes
By Mayo Clinic staff
Myoclonus may be caused by a variety of problems, including:

Head or spinal cord injury or infections
Strokes
Brain tumors
Kidney or liver failure
Chemical or drug poisoning
Prolonged oxygen deprivation
Multiple sclerosis
Epilepsy
Parkinson's disease
Alzheimer's disease
Metabolic problems

Preparing for your appointment
By Mayo Clinic staff
You'll probably first discuss your concerns with your family doctor, who may decide to refer you to a neurologist. Because appointments can be brief, it's a good idea to come prepared to make the best use of the time allotted.

What you can do

Write down a list of your symptoms, noting if there's anything that seems to trigger them or make them better.
Take a list of all your medications, including any vitamins or supplements.
Compile a list of questions for your doctor, asking about possible causes, treatments and prognosis.
What to expect from your doctor
Your doctor will ask you to describe your myoclonus symptoms in detail. He or she may also ask if you have a history of:

Seizures
Any other neurological problems
Drug or chemical exposure
Other medical problems
Family members with a similar problem or epilepsy
Your doctor may try to provoke your myoclonus symptoms, so he or she can see how many muscle groups are involved and if there are any other neurological abnormalities that occur at the same time.

Tests and diagnosis
By Mayo Clinic staff
Determining the cause of myoclonus usually is a process of elimination. To rule out potential causes, your doctor may recommend the following types of tests:

Electroencephalography (EEG)
This procedure records the electrical activity of your brain and may help determine from which part of the brain the myoclonus appears to originate. EEGs are painless and take less than an hour. Small electrodes are attached to your scalp with paste or an elastic cap. You may be asked to breathe deeply and steadily for several minutes or to stare at a patterned board. At times a light may be flashed in your eyes.

Electromyography (EMG)
This test measures the electrical discharges produced in muscles. Very fine wire electrodes are inserted into the muscles your doctor wants to study. This may be uncomfortable, but most people are able to complete the test. An instrument records the electrical activity from your muscle at rest and as you contract the muscle, such as by bending your arm. These signals help determine if there's damage to the muscle or to the nerves leading to the muscle. The test takes at least an hour to complete.

MRI
This scan may be used to check for such things as structural problems or tumors inside your skull, which may be causing your myoclonus symptoms. MRIs use radio waves and a powerful magnet to produce detailed images of internal organs. The scan itself is noisy but painless, although some people experience claustrophobic feelings.

Laboratory tests
Your doctor may want to test your blood or urine for evidence of:

Metabolic imbalances
Autoimmune disease
Diabetes
Kidney or liver disease
Drugs or toxins

Treatments and drugs
By Mayo Clinic staff
Treatment of myoclonus is most effective when a reversible underlying cause can be found — such as a medication or toxin that can be discontinued or "flushed out" of your body. There are no drugs specifically designed to treat myoclonus, but doctors have borrowed from other disease treatment arsenals to relieve myoclonic symptoms.

Medications
Medications that doctors commonly prescribe for myoclonus include:

Tranquilizers. Clonazepam (Klonopin) is the most common drug used to combat myoclonus symptoms.
Anticonvulsants. Drugs used to control epileptic seizures have also proved helpful in reducing myoclonus symptoms. The most common anticonvulsants used for myoclonus are divalproex sodium (Depakote), primidone (Mysoline) and levetiracetam (Keppra).
Immunosuppressants. These may be used to treat specialized forms of myoclonus that occur only in children. They may include adrenocorticotropic hormone (ACTH), azathioprine (Imuran), corticosteroids or immunoglobulin therapy (IVIg).
Therapies
Botulinum toxin type A (Botox) injections may be helpful in treating various forms of myoclonus, particularly if only a single area is affected. Botulinum toxins block the release of a chemical messenger that triggers muscle contractions.

Surgery
If your myoclonus symptoms are caused by a tumor or lesion in your brain or spinal cord, surgery may be an option.

I have issues with this and have MS. I use Mysoline and it HAS to be BRAND and not generic in order to get the best response.

Don't know why as many generic drugs are alright. But I was told this by the Neuro that prescribed it for me.

Once, my Dr forgot to writs BRAND Necessary on the script and the pharmacy sent Primidone which is the generic. If figured I would try it since I had it and they would not replace it. I looked like I was either having a personal earthquake or was going to break into some serious dance moves!

Needless to say, I no longer use the generic:)

I don't know if this is what I had early on, however. I had twitches and barbs of pain in my feet and lower legs. especially at bed time.

Sounds similar however, my case didn't sound as severe.

what seemed to help me was a balanced diet, a multivitamin, and careful monitoring of my potassium levels.

I also had really bad leg cramping. My symptoms have subsided.

Of interest in this case are my med list. Amiloride, furosemide, lyrica, omeprasole, KCL, Multivit.

Is is he any diruetics? How much, and what is his potassium like?

Bring this up with his doctor and see if it rings any bells.

Cheers
PK