title: Volatile anesthetic for the control of posthypoxic refractory myoclonic status.
abstract: Posthypoxic myoclonus (Lance-Adams syndrome) is characterized by myoclonus involving multiple muscle groups which is resistant to most conventional antiepileptic drugs. We present a case of hypoxic brain injury-induced myoclonic status epilepticus successfully controlled with isoflurane. The antimyoclonic effects of isoflurane are likely due to potentiation of inhibitory postsynaptic GABAA receptor-mediated currents and its effects on thalamocortical pathways. It is effective even when intravenous agents fail to control myoclonus. It may be a useful alternative to intravenous anesthetics as a third tier therapy in patients with refractory status myoclonus.
authors.affiliation: Department of Neuroanaesthesia, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Rayadurg
authors.affiliation: Department of Neuroanaesthesia, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Radhakrishnan
authors.initials: R
authors.lastname: Muthuchellappan
authors.affiliation: Department of Neuroanaesthesia, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Umamaheshwara
authors.initials: U
authors.lastname: Rao
keywords: Hypoxia; Lance–Adams syndrome; isoflurane; myoclonus; refractory status epilepticus