Action myoclonus following acute cerebral anoxia.
Action myoclonus secondary to posthypoxic encephalopathy is being seen increasingly with improved resuscitation techniques. A case report describes 5 specific physical and occupational therapeutic techniques for achieving independence in ambulation, transfers and self-care: (1) analysis and segmentation of complex motions into small steps; (2) controlled progression of training; (3) voluntary cessation of abnormal activity (pacing); (4) progressive densensitization to external stimuli; and (5) quantification of progress. Literature review suggests that posthypoxic action myoclonus is secondary to a loss of inhibitory synapses in the brainstem reticular formation due to low serotonin levels. The proposed therapeutic effect of clonazepam, the drug used in this patient, is decreased serotinin degredation. L-5-hydroxytryptamine, an investigative drug, is also therapeutic, for it stimulates increased serotonin production.
D000208:Acute Disease; D002998:Clonazepam / Q000627:therapeutic use; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000188:drug therapy / Q000209:etiology* / Q000534:rehabilitation; D012701:Serotonin / Q000627:therapeutic use
D012701:Serotonin; D002998:Clonazepam