The patient suffering from nocturnal myoclonus syndrome experiences burning and twitching of muscles just before he goes to sleep or during the first few hours of the sleep. This abnormal sensation is usually felt in the lower limbs; however in rare instances it can also involve the hands. Patient gets up from his sleep and moves his legs to find relief from this involuntary condition. Repeated contractions and twitching interrupts a peaceful sleep for the patient and subsequently he feels tired and sleepy during the daytime. Nowadays, nocturnal myoclonus syndrome is also referred as periodic limb movement disorder (PLM).
People often relate nocturnal myoclonus syndrome (PML) to another condition called restless leg syndrome. But there is a difference; people with restless leg syndrome may suffer from nocturnal myoclonus syndrome, however former condition is not present with nocturnal myoclonus syndrome. Middle aged and elderly individuals get affected with this disorder; it may also be associated with conditions such as uremia, diabetes, and rheumatoid arthritis. There is etiological uncertainty for nocturnal myoclonus syndrome in its primary form. Certain secondary conditions can precipitate the conditions and they are:
- Diabetes mellitus.
- Rheumatoid arthritis.
- Spinal cord tumor or injury.
- Deficiency of iron leading to iron deficiency anemia.
- Restless leg syndrome.
- Sleep apnea.
- Attention deficit hyperactive disorder (ADHD).
- Certain drugs such as antidopaminergic, dopaminergic, or tricyclic drugs.
- Withdrawal of barbiturate and benzodiazepine drugs can also trigger the disorder.
- People who work in shifts.
- People who snore.
- Coffee and other stimulants.
An estimated 4% of adults and especially women and elderly individuals are known to experience the symptoms.
Can Nocturnal Myoclonus Syndrome be Treatment Completely?
Before starting the treatment, it is necessary to confirm the diagnosis of nocturnal myoclonus syndrome. Most often nocturnal myoclonus syndrome (PML) is reported by the bed partner or the patient. Repeated involuntary movements of legs during night sleep and sleepiness during day are usual symptoms that indicate the disorder.
The physician suspecting the disorder from detailed history will now suggest a polysomnogram. It is a test to confirm the presence of this disorder.
He will also suggest blood tests to rule out uremia, anemia, diabetes, etc. He will also advise for an EEG, test to rule out epileptic seizures.
There is no definite cure for this disorder; however treatment is aimed to relieve the symptoms of this disorder.
If any of the triggering factors are detected, treatment will be focused to treat and control the condition such as diabetes, arthritis, etc.
Certain lifestyle changes will also help to relieve the symptoms, for example eliminating coffee and other stimulants, and avoiding sugar, candies and chocolates etc.
Regular exercise such as a brisk 30 minutes walk or swimming, cycling etc can be helpful.
If the patient is found anemic, he will be advised to take iron or folic acid supplements. Including iron and vitamin rich foods in diet such as spinach, liver etc is beneficial.
Medications and drugs: anti epileptics or benzodiazepines or narcotic pain killers are prescribed by the doctor in many instances.