Benign neonatal sleep myoclonus

  • common non-epileptic condition misdiagnosed as epileptic seizures and even as infantile spasms.
  • Onset is from the first day to 3 weeks of life with a peak at the seventh day
  • The myoclonus occurs during non-REM sleep in otherwise normal neonates
  • mainly affects the distal parts of the upper extremities with the lower limbs and axial muscles less often involved
  • the myoclonic jerks, synchronous or asynchronous, unilateral or bilateral, mild or violent, usually last for 10–20 s
  • occasionally they may occur in repetitive clusters of 2–3 s for 30 min or longer imitating myoclonic status epilepticus or a series of epileptic fits
  • the myoclonic jerks may get worse with gentle restraint
  • they abruptly stop when the child is awakened
  • sleep is not disturbed
  • not associated with apnoea, autonomic disturbances, automatisms, eye deviation, oral–buccal–lingual movements or crying.
  • normal neurology
  • unknown
  • does not appear to be familial
  • likely to be generated in the brain stem.
  • all investigations including sleep EEG are normal
  • excellent with the myoclonus commonly remitting by the age of 2–7 months.
  • no need for any treatment
  • minute doses of clonazepam before bed are often beneficial[1]. Other anti-epileptic drugs are contraindicated.

1. a Panayiotopoulos CP. (2005). The Epilepsies: Seizures, Syndromes and Management. Oxfordshire (UK): Bladon Medical Publishing
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