Do you feel that you are falling before you fall asleep? Where is it coming from?

Probably each of us has experienced a strange feeling of falling asleep. This is a muscle contraction known as a “myoclonic jerk”. Is this phenomenon dangerous to our health? What is the cause of this spurt?

Myoclonic jerk – what is it?

Myoclonic jerk (sleepy myoclonus) is a gentle muscle contraction that occurs before you fall asleep, when you go from awake to sleep. These contractions are accompanied by a falling sensation that causes you to wake up suddenly. The contractions can affect individual muscles as well as whole groups. The cause of this is our brain, which sends electrical impulses to the muscles.

Almost all of us have experienced a myoclonic spurt at least once. The reason for this is not exactly known. However, there are factors that may favor its occurrence. It is stress, fatigue, sleep deprivation, coffee or alcohol drunk before bedtime.

Physiological myoclonus can also appear during exercise or vigorous movement. Hiccups are also a symptom of myoclonus.

Rare myoclonic jerks are not a cause for concern. They do not require consultation with a doctor and are usually not a symptom of a disease.

Myoclonus – causes

Sometimes, however, myoclonus can be a symptom of neurological and metabolic diseases. We are then dealing with pathological myoclonia.

We divide pathophysiological myoclonus into:

  1. spinal myoclonus,
  2. cortical myoclonus,
  3. trunk myoclonus (fast and rhythmic),
  4. subcortical myoclonus (free and irregular).

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The causes of pathological myoclonus can be:

  1. epilepsy
  2. dementia diseases (Alzheimer’s disease, Parkinson’s disease, dementia with Lewy bodies),
  3. metabolic diseases (hyperthyroidism, liver or kidney failure)
  4. brain injuries, encephalopathy
  5. storage diseases (Gaucher disease, Tay-Sachs disease)
  6. toxoplasmosis
  7. poisoning with drugs and heavy metals
  8. viral brain infections (Creutzweld-Jakob disease, malaria, Lyme disease)

Myoclonus – examination and treatment

The basic issue in the diagnosis of myoclonus is physical examination and a detailed interview, taking into account past illnesses, family conditions, medications taken, possible contact with toxins and the circumstances in which outbreaks occurred.

Your doctor will be responsible for distinguishing between myoclonus attacks and other movement disorders.

You may need to test your electrolytes, as well as your glucose, creatinine, urea, bilirubin, and AST and ALT enzymes. EEG examination, brain imaging (computed tomography, magnetic resonance imaging), cerebrospinal fluid examination, and genetic tests may also be required.

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Treatment of myoclonus depends on identifying the underlying cause. If the underlying cause is neurological or metabolic diseases, treatment of the underlying disease is initiated. When the cause is stress, micronutrient deficiencies, mood disorders, the therapy is aimed at minimizing the risk factor.

When spontaneous myoclonus occurs, due to the inability to diagnose the cause, there is no effective therapy, only symptomatic treatment is possible.

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