In children, benign neonatal sleep myoclonuses may occur and are often associated with abnormal movements during sleep. Most children with this disorder are healthy, although some children may develop mild neurologic findings, such as hypoxia and hyperirritability. However, long-term follow-up has shown that tonal abnormalities are often present in this condition. So, how do we know if our child is suffering from this condition?
Benign neonatal sleep myoclonus is a relatively rare condition in infants and is not dangerous, however, it is sometimes misdiagnosed or even mistaken for other disorders. Symptoms of benign neonatal sleep myoclonus can mimic those of periodic limb movement disorder, which causes involuntary movements of the arms, legs, and sometimes even the head. Because these movements are nonconvulsive, there is no need for treatment, although it is advisable to seek medical advice in order to make sure the infant does not develop seizures.
Symptoms of BMEI include generalized muscle rigidity and nocturnal myoclonus. While this condition is often mistaken for epilepsy, it is also a sign of generalized muscle rigidity in neonates. The onset of this condition coincides with the occurrence of an exaggerated response to stimuli. In some cases, the infant will have repeated falls or apnea.
Infants sometimes wake up with a short, sharp shudder that may be just a baby’s dream. While some adults joke about infant dreams, others worry about the potential for seizures. This sudden movement is known as myoclonus and has been defined by the National Institutes of Health as an involuntary, brief jerking movement of the body. It can be confused with hiccups.
In one report, a term female neonate (26 weeks gestation) was born by caesarean section due to transverse lie. She had a jerky limb movement that occurred every one to two minutes during her sleep. It disappeared when the baby was woken. The neonate had no other complaints and no family history of seizures. The neonate was analyzed for possible neurological abnormalities. The baby was diagnosed with benign neonatal sleep myoclonus, and she was discharged for breast-feeding.
The diagnosis of a newborn with this condition is based on the perinatal history and physical examination. It is important to note that the jittery behaviour is caused by a disorder in the perioral muscles, but the symptoms are generally harmless and may be temporary. If the neonate remains unwell after the onset of the symptoms, further tests may be necessary. If the baby is unresponsive to physical or mental stimulation, the neonatal sleep tremor may be indicative of a more serious condition.
Although the cause of benign neonatal sleep myoclonism is still unknown, it is usually harmless. This condition can be misdiagnosed as other disorders, but it is not dangerous. If it continues for more than a few weeks, it can become an issue and require medical treatment. A neonatal child with this condition should be evaluated by a pediatrician to determine whether it is benign or needs medical attention.
Benign neonatal sleep myoclonus is a condition characterized by intermittent myoclonic jerks of the extremities that occur only during sleep. The condition is not associated with epilepsy or other neurologic impairments, and typically subsides after six months of age. It is important to differentiate it from other sleep disorders, including epilepsy, which can lead to unnecessary treatments and extensive diagnostic tests.
While the cause of benign neonatal sleep myoclonic disorder is unknown, a study in 2004 published by Coulter and Allen suggested that it may be a result of a benign discharge in the brainstem reticular activating system, which controls sleep initiation. Another case series report suggested that this condition may be the result of transient immaturity of the serotoninergic system.
There are several possible causes of this disorder. One of these is repeated noise or rocking the infant. The second possible cause is repetitive motion during sleep. In fact, the infant may be agitated by repeated sound. Holding limbs during sleep can exacerbate the condition. BNSM does not resolve by three months of age. The study, however, is limited due to the small number of cases reported.
Researchers have proposed a list of potential causes of benign neonatal sleep myoclonic disorder. Volpe JJ, Rizzi M, and Goraya JS have outlined the literature related to the condition. Researchers in the field have also found that benzo-diazepines may trigger this condition. The authors of this article recommend that the patient be monitored for symptoms of this disorder and seek treatment as soon as possible.
In most cases, benign neonatal sleep myoclonuis episodes resolve spontaneously within six months or a year of birth. However, some children can be severely affected, and medical treatment may include anticonvulsant drugs and the use of brain imaging to assess the baby’s brain activity. Ultimately, the best treatment for benign neonatal sleep myoclonus is observation.
BNSM is often mistaken for epileptic seizures in infancy. Early recognition of this condition can help to prevent unnecessary diagnostic studies and treatments. The symptoms of this disorder include jerky movements and jitteriness/clonus, which occur due to poor myelination of the corticospinal tract in neonates. BNSM may be due to other factors, including developmental anomalies, drugs, or hematological problems.
If the child is not experiencing any other medical conditions, a gentle restraint may be used. Anticonvulsant medications should be used only when the neonate is experiencing epileptic symptoms. In cases where anticonvulsant therapy fails to relieve the symptoms, the use of an anticonvulsant can worsen the condition. However, anticonvulsant medication is often not an effective treatment for benign neonatal sleep myoclonus.
The cause of benign neonatal sleep myoclonic seizures is not clear. The underlying neurophysiology is not fully understood, but neurophysiologists have discovered that immature serotonergic pathways in the brainstem may cause jerky movements in infants. While EEG does not show abnormalities during the jerks, antiepileptic medication is unlikely to reduce the risk of epileptic seizures in these cases.
A recurrent episode of myoclonic jerks is not considered a medical emergency, and most babies outgrow this condition by 3 months. The incidence of benign neonatal sleep myoclonus is 0.8 to three cases per thousand live births. Rocking, repetitive sound, and tactile stimuli have been reported to worsen the episode. Treatment of benign neonatal sleep myoclonus is unrelated to epilepsy and can be successfully managed.
A common cause of nocturnal myoclonus is the over-reactive neurotransmitter Xenazine. Xenazine, a drug used to treat movement disorders, can prevent or control the episodes of myoclonus. The symptoms of this disorder may vary depending on the underlying cause. Although myoclonus is generally benign, treatment should be used only when the condition is severe enough to interfere with the child’s quality of life.
Benign neonatal sleep myoclonus occurs at birth, usually within the first month, and often occurs during quiet sleep. In rare cases, the condition can begin as early as a few hours after birth. Benign sleep myoclonus occurs in all sleep states, with the highest prevalence occurring during quiet and intermediate stages. The duration of the disorder varies from two to four months, rarely extending into early childhood.
The duration of benign neonatal sleep myoclonic episodes ranges from a few minutes to one hour. It is often mistaken for status epilepticus and may be caused by anticonvulsant medications. While myoclonus is not an indication for anticonvulsant medications, it can be treated with gentle restraints. It is important to note, however, that if a patient develops myoclonus, their condition should be evaluated by a physician.
The duration of benign neonatal sleep myoclonic episodes varies, but the majority subside spontaneously and without neurologic deficits. It is unlikely to cause any developmental delays and is usually asymptomatic after three to four months. Typically, infants affected by benign sleep myoclonus have normal cognitive and psychomotor development, and EEGs during the episodes are typically normal.
While benign neonatal sleep myoclonu is not harmful, it can be confused with other conditions that require treatment. For example, if a baby’s mother is addicted to opioids, they may have seizures. If this happens, they should be evaluated by a pediatrician. If the condition occurs more than twice a week, the pediatrician should immediately consult a medical professional.
Despite its relatively short duration, BNSM is an underdiagnosed disorder in newborns. Its onset and duration range from four to eight weeks, with most children resolving within three months. Benign neonatal sleep myoclonus can lead to mild speech delays or axial tone in some children, and there are some cases where an infant develops epilepsy on follow-up.
Benign neonatal sleep myoclonus is a self-limiting disorder that manifests itself during the NREM stages of sleep. It usually resolves with arousal. Symptomatic episodes of BNSM may be induced by rocking or repetitive sound stimuli. In addition, holding limbs during sleep may worsen symptoms. Benign neonatal sleep myoclonus may persist in infants for three to four months, but the number of cases reported to date make it difficult to make a definitive diagnosis.