Spinal-generated movement disorders: a clinical review

Table 2 Pharmacological treatment of each spinal-generated movement disorder

SGMDs	CLZ	VPA	LVT	CBZ	GBP	ImRx^a	Others
Spinal segmental myoclonus (SSM)	+	+	+
Propriospinal myoclonus (PSM)	+	+
Orthostatic tremor (OT)	+				+		+^b
Paroxysmal tonic spasms in multiple sclerosis (MS)				+			+^c
Stiff person syndrome (SPS) and its variants	+/−^d					+	+^e
Progressive encephalomyelitis with rigidity and myoclonus (a variant of SPS)	+/−^d					+	+^e
Painful legs-moving toes syndrome (PLMT)	+^f			+^f	+		+^g

Pharmacologic therapies in SGMDs. The effective or possibly effective therapies are indicated by “+”. Drugs utilized in SGMDs are mostly antiepileptics (including benzodiazepines, especially clonazepam, valproate, levetiracetam, carbamazepine, and gabapentin), and immunotherapies^a (including steroids, intravenous immunoglobulin, and/or plasma exchange, as well as immunosuppressants such as azathioprine, cyclophosphamide and mycophenolate mofetil)
Abbreviations: SGMDs spinal-generated movement disorders, CLZ clonazepam, VPA valproate, LVT levetiracetam, CBZ carbamazepine, GBP gabapentin, ImRx immunotherapies
^bDopaminergic therapies including dopamine agonists and levodopa in case with co-existing parkinsonism
^cAcetazolamide
^dClonazepam may be used, but anecdotally is less effective than diazepam
^eBenzodiazepines, especially diazepam
^fIn our experience, these medications are used less often than gabapentin
^gPregabalin is also used. Other medications reported in small number of patients include baclofen, carbamazepine, and tricyclic antidepressants

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