How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Frank Your Own Question

Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
64994909
Type Your Neurology Question Here...
Dr. Frank is online now
A new question is answered every 9 seconds

I have been having jerking/muscle spasms all on my right side

Customer Question

I have been having jerking/muscle spasms all on my right side of my body. It causes me to not sleep. I do have grand mal,but it has been over ten years since I had one of those. I always get these other things and I'm not sure what they are.
Submitted: 2 years ago.
Category: Neurology
Expert:  Dr. Frank replied 2 years ago.

neuromd2012 :

HI

neuromd2012 :

I am an adult neurologist, and will attempt to answer your question. You are offline, so please review the following information and ask questions if you have them , or if you are asked to answer my questions, please do so and I will return to reply. If you feel you have recieved enough information and are satisfied, please hit the accept button as that is how I am compensated for my work. If you have additional questions, even after you have hit the accept, for example you now have lab results, please return and I will be glad to answer your questions. Please be aware that as a physician I cannot make a diagnosis without an examination, so this is for information purposes only and does not adhere to the role of a patient-physician relationship. Ok?

neuromd2012 :

are you in the chat room?

neuromd2012 :

please type something for me

Customer: I am here
neuromd2012 :

great

neuromd2012 :

so you have gen T/C seizures since when?

Customer: Since I was 11 years old
neuromd2012 :

was it febrile seizures at the beginning, or do you have a diagnosis?

neuromd2012 :

no history of meningitis or any known cause?

Customer: What is that all I know is that they said I had grand mal seizure
Customer: Not that I know
neuromd2012 :

ok and how much phenobarb do you take?

Customer: 90mg at night
Customer: Could these be myoclonic
neuromd2012 :

yes, that is what they sound like

neuromd2012 :

but it may be nocturnal myoclonus only, does it occur only at night?

Customer: If so what is recommended
neuromd2012 :

well I would add some klonopin, but I would do so in the context of weaning you down on the phenobarbital, as that might be the real problem

Customer: No I have been having them all day. Sometimes a startle could even make it happen
neuromd2012 :

so you have startle myoclonus

neuromd2012 :

we have great names in neurology, don' t we?

neuromd2012 :

have you ever tried klonopin?

Customer: Yes sometimes I feel lost in the words
neuromd2012 :

who put you and keeps you on phenobarbital???

neuromd2012 :

90 mg, what is your phenobarb level?

Customer: No I have tried keppra deprokote pheno teratology neurotin
Customer: My neuro from unassuming memorial hosp
neuromd2012 :

but you haven't had a GTC seizure in 10 years? why the changes?

neuromd2012 :

well if you want my opinion, phenobarb is like stoneages, nobody uses phenobarb anymore,

neuromd2012 :

nobody

Customer: For these episodes but nothing seems to help
neuromd2012 :

did he start the phenobarb for the startle myoclonus?

Customer: These happen so often in my life it's crazy
Customer: No I have been on pheno since I was a teenager
Customer: Someone could bump into me by accident and the episode will happen I don't know how to stop it
neuromd2012 :

well my approach in your situation would be an attempt to slowly, and I mean very slowly, wean you off the phenobarbital and start something like Mysoline as a replacement, and then probably change to klonopin later on, in an attempt to decrease your myoclonus without sedating you too much. Phenobarbital causes cognitive impairment, do you work?

Customer: For the past two nights they also start when I want to go to sleep. Which I can't because of it
neuromd2012 :

yes, well you might ask you neurologist if you could have some 0.5 or 1.0 mg klonopin to take right before you go to bed , before the myoclonus starts

Customer: Yes retail but it happens on the job. The job isn''t the only time. Like I said little things bring it on and it causes me to drop because of the right leg/arm spasms are so bad
neuromd2012 :

well that is my suggestion, you need to make some changes in your medications if you want my opinion, maybe find an epileptologist to treat you rather than a neurologist only, I don't prescribe phenobarb anymore, and I have been successful getting my patients off phenobarb, using drugs like Vimpat and Klonopin. you can function better

Customer: What is the difference
neuromd2012 :

I would push your keppra up to 3000 mg/ day if necessary, and drop both your phenobarb, and eventually maybe your dilantin, keep you on keppra and vimpat or klonopin

neuromd2012 :

big difference in these drugs, less cognitive impairment, less side effects, your myoclonus might be from being on the phenobarb for so long

neuromd2012 :

the newer drugs are better than the old drugs.

Customer: I get nervous changing meds so much cause I don't want to have a grand mal. How would I know that those meds would keep my grand mal under control
Customer: Why do you think that the pheno could be the cause.
Customer: Are you there
neuromd2012 :

That is about all I can add now. Please hit the accept button if you feel I have answered your question and that is how I get compensated for my time with you. thank you. dr Frank T.

neuromd2012 :

If you want literature about phenobarb I can find some for you

Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and other Neurology Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex Los Angeles, CA
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP Hesperia, CA
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin Kernersville, NC
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther Woodstock, NY
  • Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know. Robin Elkton, Maryland
 
 
 

Meet The Experts:

 
 
 
  • Dr. Mark

    Neurologist (MD)

    Satisfied Customers:

    1985
    Neurosurgeon - Brain, spine, and peripheral nerve surgery
< Last | Next >
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Neurologist (MD)

    Satisfied Customers:

    1985
    Neurosurgeon - Brain, spine, and peripheral nerve surgery
  • http://ww2.justanswer.com/uploads/NE/neuromd2012/2012-6-6_171449_frank.64x64.jpg Dr. Frank's Avatar

    Dr. Frank

    Board Certified Physician

    Satisfied Customers:

    6629
    Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
  • http://ww2.justanswer.com/uploads/jesbrain2015/2010-5-21_162329_jack.jpg Jack Scariano Jr's Avatar

    Jack Scariano Jr

    Neurologist (MD)

    Satisfied Customers:

    1056
    Board Certified Neurology 1982 30 years experince. Also expert in Pain Medicine
  • http://ww2.justanswer.com/uploads/PR/pradocs/2012-7-23_23649_201272323220JApicture105x113.64x64.jpg Dr. Bob's Avatar

    Dr. Bob

    Neurologist (MD)

    Satisfied Customers:

    2846
    Neurology & Int Medicine (US Trained): 20 yrs experience
  • http://ww2.justanswer.com/uploads/HE/healthydoc/2011-7-22_193154_LevGrinman2.64x64.jpg healthydoc's Avatar

    healthydoc

    Board Certified Physician

    Satisfied Customers:

    1848
    Board Certified U.S. Neurologist
  • http://ww2.justanswer.com/uploads/BrainLifeDoc/2010-10-04_004701_AMF_2008_2_pix.jpg Dr. F's Avatar

    Dr. F

    Board Certified MD

    Satisfied Customers:

    266
    Neurosurgeon with more than 20 years experience in practice and teaching.
  • http://ww2.justanswer.com/uploads/Phytube/2010-9-7_192331_PicVB1a_164by64.jpg Phytube.com's Avatar

    Phytube.com

    Neurologist (MD)

    Satisfied Customers:

    86
    Pediatric Neurology and Developmental Medicine with Special Research In Pain Medicine/Medications
 
 
 

Related Neurology Questions