Benign Neonatal Sleep Myoclonus Treatment & Management

Updated: Jan 02, 2015
  • Author: Marc P DiFazio, MD; Chief Editor: Ted Rosenkrantz, MD  more...
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Treatment

Medical Care

Medical care of benign neonatal sleep myoclonus (BNSM) consists of making a timely diagnosis. Delayed recognition often results in extensive diagnostic testing, including screening for infectious causes of seizures (eg, spinal tap, blood cultures, empiric antibiotics) and neurodiagnostics (eg, electroencephalography, brain imaging, brain monitoring). This process almost invariably results in admission to the hospital and a great deal of family distress.

Early recognition can be facilitated by the use of home-video monitoring by parents, especially if the episodes are frequent. If the child is otherwise clinically well, ask the parents to obtain video footage while their child undergoes medical evaluation. Once a provider is experienced in the clinical manifestations, this can be invaluable in the diagnosis of benign neonatal sleep myoclonus. At that point, parents are reassured regarding the benign nature of the condition and educated regarding the prognosis. If clinical concern for possible seizure remains but the child is otherwise clinically stable (eg, without concerning pregnancy-related risk factors or abnormal findings on examination), admission to the hospital for a short stay to facilitate monitoring and observation by trained professionals is prudent.

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Consultations

If clinical confusion remains, a pediatric neurologist should be consulted to observe video footage and to perform an extended neurologic examination. Further diagnostic testing could be ordered based on their assessment and based on concern regarding possible seizures or other more ominous causes of myoclonus in children. This would be especially pertinent in patients with late-onset manifestations or with other concerning neurologic findings.

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