Postanoxic myoclonus: two case presentations and review of medical management.
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.
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. Electronic address: adrian.budhram@medportal.ca.
Adrian
A
Budhram
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.
David
D
Lipson
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.
Shanker
S
Nesathurai
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.
David
D
Harvey
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.
Michel P
MP
Rathbone
D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D002998:Clonazepam / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D000860:Hypoxia / Q000150:complications; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000188:drug therapy* / Q000209:etiology; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014635:Valproic Acid / Q000008:administration & dosage / Q000627:therapeutic use*
D000927:Anticonvulsants; D000077287:Levetiracetam; D002998:Clonazepam; D014635:Valproic Acid; D010889:Piracetam
Case report; Myoclonus; Rehabilitation