Spasm disorders encompass a number of conditions such as restless legs syndrome, periodic limb movement disorder, and tardive dyskinesia, among others. Muscle twitches are the result of spontaneous local muscle contractions that are involuntary. These contractions usually affect individual groups of muscles connected to a particular motor neuron in the body. Some muscle twitches are normal whereas others indicate a neurological disorder. Muscle spasms can cause cramps, and may be induced by certain drugs. Serious causes of spasms, such as motor neuron disease, muscle diseases, or denervation, may be accompanied by weakness, muscle wasting, and other symptoms.
Epilepsy is a brain disorder in which clusters of nerve cells in the brain have abnormal signaling, which causes strange sensations, emotions, and behavior, and sometimes seizures, muscle spasms, and loss of consciousness. Epilepsy can be caused by other disorders or injury. Doctors have identified more than 30 different types of seizures. About 60% of people with epilepsy have focal (also known as partial) seizures.
Commonly Prescribed (On-Label) Drugs: Acetazolamide, Carbamazepine, Ethotoin, Fludeoxyglucose F 18, Levetiracetam, Mephenytoin, Methsuximide, Oxcarbazepine, Phenacemide, Phenobarbital, Primidone, Secobarbital, Zonisamide
Off-Label Prescription Drug Breakthrough Option: Pregabalin
Gilles de la Tourette Syndrome, or Tourette’s Syndrome (TS), is a neurological disorder characterized by tics (involuntary, rapid, sudden movements or vocalizations that occur repeatedly in the same way). The most common first symptom is a facial tic such as rapidly blinking eyes or mouth twitches. Involuntary sounds such as throat clearing and sniffing, or tics of the limbs may be first signs of TS. The cause of TS is not clear although the disorder may stem from abnormal activity of the brain chemical (neurotransmitter) dopamine. Other neurotransmitters and receptors may be involved.
Commonly Prescribed (On-Label) Drugs: Haloperidol
Off-Label Prescription Drugs Breakthrough Options: Baclofen, Clonazepam, Clonidine, Guanfacine, Risperidone, Ziprasidone
Hiccups are repeated spasmodic involuntary contractions of the diaphragm that occur when you inhale. Practically everyone has hiccups at some point, but they usually go away. Chronic episodes lasting longer than 48 hours are called intractable hiccups and can be invasive, causing sleep difficulties, inability to eat, and depression. This spasm disorder may be triggered by certain foods, drinks, drugs, or behavior; treatments include drugs and other non-drug interventions.
Commonly Prescribed (On-Label) Drugs: Chlorpromazine
Off-Label Prescription Drugs Breakthrough Options: Baclofen, Carbamazepine, Gabapentin, Haloperidol
Huntington’s disease is a progressive, degenerative, and inherited disease that causes certain nerve cells in the brain to waste away. Signs and symptoms of Huntington’s chorea (incessant, quick, and jerky movements seen with this disorder) usually develop during middle age. The earliest signs and symptoms of Huntington’s disease often include personality changes and decreased cognitive abilities. A person with early disease may be irritable, angry, paranoid, or depressed. As the disease progresses, a person may develop sudden, jerky, involuntary movements throughout the body and other symptoms.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Clozapine, Olanzapine, Riluzole, Ziprasidone
Periodic limb movement disorder (PLMD) is one of the most common neurological disorders. It affects people only during sleep, and is characterized by behavior ranging from shallow, continual movement of the ankle or toes, to wild and strenuous kicking and flailing of the legs and arms. Movement of the legs is more common than arm movement. Abdominal, oral, and nasal movement may accompany PLMD. Movements generally occur for 0.5 to 10 seconds, in intervals separated by five to 90 seconds. Arousals or awakening may be associated with the movements. The incidence of PLMD increases with age.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Bromocriptine, Carbidopa-levodopa, Clonazepam, Pergolide, Selegiline
Restless legs syndrome (RLS) is a sensory-motor disorder that affects up to 10% of the population. Features of RLS include a desire to move the limbs; abnormal, uncomfortable, and/or painful sensations in the lower extremities; motor restlessness; a partial and temporary relief of these symptoms with activity; and worsening of symptoms in the evening or night. RLS can occur at any age, although it is usually seen in adults and tends to worsen with age. Motor symptoms of RLS include periodic leg movements (PLMs) that can occur during wakefulness or sleep.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Aripiprazole, Clonazepam, Gabapentin, Pergolide, Pramipexole, Tramadol
Stuttering is a disruption of the normal pattern, rhythm, or timing of speech. Stuttering may present itself by repetition and prolongation of words, phrases, and sounds; it can also include hesitations or pauses that interrupt speech flow. Stuttering may be caused by developmental factors (occurring in childhood) or stroke or head injury. Mild stuttering is rarely treated, but persons with more severe forms of stuttering may need speech therapy or drug treatment.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drug Breakthrough Option: Paroxetine
Tardive dyskinesia is a neurological syndrome caused by the long-term use of neuroleptic drugs (drug prescribed for psychiatric, GI, and some neurological disorders). It is characterized by repetitive, involuntary, purposeless movements (e.g., grimacing, lip smacking, rapid eye blinking, rapid movement of the arms and legs). Persons with tardive dyskinesia are treated on an individualized basis. The first step of treatment is to stop or minimize the neuroleptic drug, although symptoms of tardive dyskinesia can continue long after the drug is discontinued.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drug Breakthrough Option: Ondansetron
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