Recent advances in clinical neurophysiology of myoclonus

Advances in clinical neurophysiology have transformed the understanding and assessment of myoclonus. Neurophysiological techniques have made it possible to identify the neural generators of myoclonus and have provided the foundation for modern classification systems that integrate clinical phenomenology with physiological mechanisms. Many of these developments were shaped by the work of several research groups worldwide, with major influence from the contributions of Professor Mark Hallett. His studies helped to establish the central role of neurophysiology in the investigation of myoclonus. Through careful neurophysiological experiments and clinical observations, his work clarified the mechanisms underlying cortical and brainstem myoclonus and contributed substantially to the characterization of functional jerks. This review summarizes current approaches to the clinical neurophysiological evaluation of myoclonus and outlines the evolution of classification systems leading to the recent consensus framework proposed by the International Association of Parkinsonism and Related Disorders. Key neurophysiological techniques used in clinical practice are discussed, and emerging quantitative approaches, including machine-learning of neurophysiological signals, are also highlighted as potential tools to improve diagnostic precision and standardization in the evaluation of myoclonus.