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Isolated Polymyoclonus Often Mistaken for Tremor

Patients may have polymyoclonus due to cancer, autoimmunity or treatment with SSRIs or other drugs

THURSDAY, Sept. 13 (HealthDay News) -- Isolated generalized polymyoclonus is easily mistaken for tremor, and distinguishing the two is important because polymyoclonus may be due to malignancy, autoimmunity or use of selective serotonin reuptake inhibitors (SSRIs) or other drugs, researchers report in the September issue of the Archives of Neurology.

Andrew McKeon, of the Mayo Clinic in Rochester, Minn., and colleagues conducted a study of 19 adults with generalized polymyoclonus confirmed by surface electromyography, who were initially diagnosed with tremor or gait disorder.

The mean age of onset was 55 years. Five patients had autoimmunity, malignancy and/or paraneoplastic syndromes, including two with metastatic breast cancer. Seven patients were taking myoclonus-associated medications, such as opioids, SSRIs or serotonin-norepinephrine reuptake inhibitors. Myoclonus resolved in one patient after treatment for cancer, and in another after discontinuing an SSRI.

Whole-body tremulousness should "suggest consideration of the syndrome of generalized polymyoclonus, which can be easily confirmed using surface electromyography available in routine neurologic practice," the authors write. "Recognition is important because it is symptomatically treatable and may be a clue to a treatable autoimmune etiology (paraneoplastic or idiopathic) or a drug effect."

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