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Postanoxic Myoclonus: Two Case Presentations and Review of Medical Management

  • Adrian Budhram
    Correspondence
    Corresponding author Adrian Budhram, BHSc, 10 Lytton Blvd, Richmond Hill, ON, L4B 3H2, Canada.
    Affiliations
    Divisions of Neurology and Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton Health Sciences, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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  • David Lipson
    Affiliations
    Divisions of Neurology and Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton Health Sciences, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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  • Shanker Nesathurai
    Affiliations
    Divisions of Neurology and Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton Health Sciences, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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  • David Harvey
    Affiliations
    Divisions of Neurology and Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton Health Sciences, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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  • Michel P. Rathbone
    Affiliations
    Divisions of Neurology and Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton Health Sciences, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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Published:September 23, 2013DOI:https://doi.org/10.1016/j.apmr.2013.09.008

      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)
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