BENIGN
PAROXYSMAL MOTOR EVENTS
Benign
Neonatal Sleep Myoclonus
Benign neonatal sleep myoclonus
can only be diagnosed in neurologically normal fullterm neonates. The
diagnosis requires a clear history or the observation of repetitive myoclonic
limb jerks that occur only during sleep (click on
clips) and stop upon awakening.
The myoclonic activity may
last from several seconds to 90 minutes. The jerks may be felt while the
limb is held (click on third clip).
Benign neonatal sleep myoclonus
may be triggered and exacerbated by noise, rocking, and benzodiazepines.
Rocking is especially effective in triggering the events (click
on third clip).
The use of benzodiazepines
to eliminate benign neonatal sleep myoclonus may lead to sustained myoclonus
and to the misdiagnosis of status epilepticus.
Benign neonatal sleep myoclonus is not associated with electroencephalographic
seizures during the events. A 10% to 30% increase in heart rate occurs
during some events.
Interictally, the EEG is normal. Benign
neonatal sleep myoclonus may occur during any sleep stage but it occurs
more frequently during quiet sleep. The mechanism of benign neonatal sleep
myoclonus is unknown. Immaturity or imbalance of the serotonergic system
has been postulated.
In most cases there is no family history of similar events. Benign neonatal
sleep myoclonus usually disappears before 6 months of age and requires
no treatment. Benign neonatal sleep myoclonus is not associated with subsequent
neurological deficit.
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