title: [Effects of piracetam therapy in a case of Lance-Adams syndrome].
abstract: We report a 17-year-old female patient with Lance-Adams syndrome caused by anoxic encephalopathy during a severe attack of bronchial asthma. She had difficulty in writing because of action myoclonus in her arms. She also exhibited freezing gait and was unable to walk without cane. Although her gait disturbance resembled those seen in patients with parkinsonism secondary to anoxic encephalopathy, surface electromyography revealed that it was caused by action myoclonus in her legs. The presence of giant somatosensory evoked potentials and enhanced cortical reflexes in response to the electrical stimulation to her posterior tibial nerves supported our diagnosis. A combined therapy with valproate sodium, clonazepam and piracetam (15 g/day) was not effective. However, her freezing gait remarkably improved and she was able to walk without help, after the treatment with sufficient dose of piracetam (21 g/day). Cortical hyperexcitability as revealed by electrophysiological examination also improved. We concluded that the combined therapy with antiepileptic drugs and piracetam was effective in the treatment for action myoclonus. However, because the effects seemed dose-related, the dosage of piracetam needed to be increased until the optimum effects were obtained.
authors.affiliation: Department of Neuropediatrics, Fuchu, Tokyo. aizm0505@yahoo.co.jp
authors.forename: Ai
authors.initials: A
authors.lastname: Hoshino
authors.forename: Satoko
authors.initials: S
authors.lastname: Kumada
authors.forename: Fusako
authors.initials: F
authors.lastname: Yokochi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hachiya
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Hanafusa
authors.forename: Sunao
authors.initials: S
authors.lastname: Tomita
authors.forename: Ryoich
authors.initials: R
authors.lastname: Okiyama
authors.forename: Eiji
authors.initials: E
authors.lastname: Kurihara
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D020233:Gait Disorders, Neurologic / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications; D009207:Myoclonus / Q000188:drug therapy* / Q000209:etiology; D018696:Neuroprotective Agents / Q000008:administration & dosage*; D010889:Piracetam / Q000008:administration & dosage*; D013224:Status Asthmaticus / Q000150:complications; D013577:Syndrome
chemical_list: D000927:Anticonvulsants; D018696:Neuroprotective Agents; D010889:Piracetam