A physiologic and pharmacologic study in anticholinergic-responsive essential myoclonus

We report the physiologic and pharmacologic analysis in two women, aged 18 and 17 years, with essential myoclonus. Both responded to benztropine mesylate and had been functioning normally. The physiologic analysis suggested ballistic movement overflow and audiogenic stimulus-sensitive myoclonus. The pharmacologic study showed a direct and mutual antagonism of physostigmine and anticholinergic agent on myoclonus, implying cholinergic hyperactivity in the pathophysiology of myoclonus.