Myokymia Medication

  • Author: Suying Song; Chief Editor: Nicholas Lorenzo, MD   more...
 
Updated: Feb 3, 2012
 

Medication Summary

Phenytoin and carbamazepine have been proven to be effective in treating patients with generalized myokymia, specifically patients with continuous muscle fiber activity described by Isaacs syndrome. High therapeutic drug levels usually are required to reach satisfactory control of symptoms. EMG can objectively document the disappearance of myokymic discharges. Other medications, such as benzodiazepines, have been tried with no consistent benefit. Monitoring of potential adverse effects of phenytoin and carbamazepine and precautions for these drugs are no different from when they are used to treat epilepsy.

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Antiepileptic agents

Class Summary

These agents prevent seizure recurrence and terminate clinical and electrical seizure activity.

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Phenytoin (Dilantin)

 

Has promising results in patients with Isaacs syndrome. Relieves cramps and pain of involved muscles. EMG can document objective resolution of myokymic discharges. Mechanism of action possibly related to its effect on sodium channel.

Dosage adjusted according to blood level. Target level should be at high therapeutic range.

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Carbamazepine (Tegretol)

 

Has promising results in patients with Isaacs syndrome. Relieves cramps and pain of involved muscles. EMG can document objective resolution of myokymic discharges. Mechanism of action possibly related to its effect on sodium channel.

Dosage adjusted according to blood level. Target level should be at high therapeutic range.

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Contributor Information and Disclosures
Author

Suying Song  MD, Assistant Clinical Professor, Department of Neurology, NYU Medical Center

Suying Song is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Carmel Armon, MD, MSc, MHS  Professor of Neurology, Tufts University School of Medicine; Chief, Division of Neurology, Baystate Medical Center

Carmel Armon, MD, MSc, MHS is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Association of Neuromuscular and Electrodiagnostic Medicine, American Clinical Neurophysiology Society, American College of Physicians, American Epilepsy Society, American Medical Association, American Neurological Association, American Stroke Association, Massachusetts Medical Society, Movement Disorders Society, and Sigma Xi

Disclosure: Avanir Pharmaceuticals Consulting fee Consulting

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Neil A Busis, MD  Chief, Division of Neurology, Department of Medicine, Head, Clinical Neurophysiology Laboratory, University of Pittsburgh Medical Center-Shadyside

Neil A Busis, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Selim R Benbadis, MD  Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association

Disclosure: UCB Pharma Honoraria Speaking, consulting; Lundbeck Honoraria Speaking, consulting; Cyberonics Honoraria Speaking, consulting; Glaxo Smith Kline Honoraria Speaking, consulting; Pfizer Honoraria Speaking, consulting; Sleepmed/DigiTrace Honoraria Speaking, consulting

Chief Editor

Nicholas Lorenzo, MD  Consulting Staff, Neurology Specialists and Consultants

Nicholas Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, and American College of Physician Executives

Disclosure: Nothing to disclose.

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