Abstract
Postanoxic myoclonus is a rare manifestation after an anoxic event, with fewer than
150 cases reported in the literature. The condition is characterized by myoclonic
jerks, which are worse on action than at rest, and postural lapses, ataxia, and dysarthria.
The disability caused by postanoxic myoclonus can be profound, and treatment in the
rehabilitation setting is exceptionally challenging. We present 2 patients who suffered
from postanoxic myoclonus after an anoxic event, both of whom were successfully treated
with a combination of levetiracetam, valproic acid, and clonazepam. These cases act
as a framework for discussing the management of postanoxic myoclonus in the clinical
setting.
Keywords
List of abbreviations:
BID (twice a day), 5-HTP (5-hydroxytryptophan), PAM (postanoxic myoclonus), TID (3 times a day)To read this article in full you will need to make a payment
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References
- Practice parameter: prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology.Neurology. 2006; 67: 203-210
- Myoclonus after cardiac arrest: pitfalls in diagnosis and prognosis.Anaesthesia. 2009; 64: 908-911
- The syndrome of intention or action myoclonus as a sequel to hypoxic encephalopathy.Brain. 1963; 86: 111-136
- The clinical spectrum of posthypoxic myoclonus.Mov Disord. 2000; 15: 2-7
- The clinical features and prognosis of chronic posthypoxic myoclonus.Mov Disord. 1997; 12: 216-220
- Lance-Adams syndrome.Ann Rehabil Med. 2011; 35: 939-943
- The metabolic topography of posthypoxic myoclonus.Neurology. 2004; 62: 1879-1881
- Lance-Adams syndrome: a report of two cases.J Zhejiang Univ Sci B. 2007; 8: 715-720
- Post-anoxic myoclonus: a case presentation and review of management in the rehabilitation setting.Brain Inj. 2006; 20: 213-217
- Suppression of posthypoxic and post-encephalitic myoclonus with levetiracetam.Neurology. 2001; 56: 411-412
- A pilot tolerability and efficacy study of levetiracetam in patients with chronic myoclonus.Neurology. 2001; 57: 1112-1114
- HVA and 5-HIAA CSF measurements and 5-HTP trials in some patients with involuntary movements.J Neurol Sci. 1973; 18: 435-441
- Clinical, biochemical and physiological features distinguishing myoclonus responsive to 5-HTP, tryptophan with monoamine oxidase inhibitor, and clonazepam.Brain. 1977; 100: 455-487
- Long-term treatment of myoclonus and other neurologic disorders with L-5-hydroxytryptophan and carbidopa.N Engl J Med. 1977; 296: 70-75
- Serotonin receptors.Chem Rev. 2008; 108: 1614-1641
- Clinical, biochemical, and pharmacological observation in a patient with postasphyxic myoclonus: association to serotonin hyperactivity.Clin Neuropharmacol. 1988; 11: 151-160
- Animal model of posthypoxic myoclonus: effects of serotonergic antagonists.Neurology. 1999; 52: 16-21
Article info
Publication history
Published online: September 23, 2013
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
