What is sleep myoclonus?
Consultant Neonatologist,
Sir Ganga Ram Hospital,
New Delhi
Q: My son suffered from brain fever when he was 1 year 4 months old. During the infection he had two episodes of jerky movements. His doctor later called it Myoclonus. The treatment for the brain fever was successful. Since then he has had both DTP booster shots & chicken pox vaccine. I gave him calmpose syrup during his fever reaction for DTP booster shot. There was no myoclonal movement at that time. He showed no reaction for chicken pox shot. He is now 2 years old and recently had an attack of viral infection. His fever went upto 102.3 degree F. During sleep he showed myclonal movements. He was given Frisium 2.5 mg, 8 hourly for 3 days and then 12 hourly for 2 days and then stopped when the fever reduced to below 100. He showed these movements only when he was sleeping during the high fever. My questions are, what side effects does Fresium have on a child as young as my son? Do I have to give Fresium every time I think he is coming down with a fever? If left untreated, can these myoclonal movements lead to something more severe? He did not show any myoclonal movements during high fevers he has had prior to his brain fever, so does that mean this condition has started because of the brain fever? In general whenever he goes to sleep, for the first 5 to 10 minutes after drifting off to sleep, there are small movements in the limbs - like clenching of fist, wiggling toes, slight shift in position of the arm etc ... are these normal or are they indicative of an underlying problem?
A:There are two issues in your question. First regarding sleep myoclonus. This is a benign condition which does not require any treatment. These jerks occur during first phase of sleep for first few minutes when the sleep is light also called REM sleep. The best way to confirm is when the child is having jerks, wake him and the jerks will stop. Regarding convulsions or jerks during fever. Babies who are prone to develop jerks during fever should be taken care to keep their temperature under control. Probably this is the most effective way of preventing convulsions. Many medications have been tried to prevent convulsions during episodes of fever and Fresium is one of them. It is usually a safe medicine except that it may cause some sedation or sleepiness. It has been used for the duration of fever or for 2-3 days. Child should not have any long lasting effects.