Post-hypoxic myoclonus; what we know and gaps in knowledge

Trop Doct. 2023 Oct;53(4):460-463. doi: 10.1177/00494755231181153. Epub 2023 Jun 7.

Abstract

Post-hypoxic myoclonus (PHM) is a rare neurological complication having two different variants depending on acute or chronic onset after cardiopulmonary resuscitation following cardiac arrest: myoclonic status epilepticus (MSE) and Lance-Adams syndrome (LAS) respectively. Clinical and simultaneous electro-encephalographic (EEG) and electromyographic (EMG) tracing can distinguish between the two. Anecdotal treatment with benzodiazepines and anaesthetics (in the case of MSE) have been tried. Although limited evidence is available, valproic acid, clonazepam and levetiracetam, either in combination with other drugs or alone, have shown to control epilepsy associated with LAS effectively. Deep brain stimulation is a novel and promising advance in LAS treatment.

Keywords: Diagnosis < other; cardiovascular < physiology; community health; nervous < physiology; treatment < other.

Publication types

  • Review

MeSH terms

  • Cardiopulmonary Resuscitation* / adverse effects
  • Clonazepam / therapeutic use
  • Humans
  • Hypoxia / complications
  • Hypoxia / therapy
  • Myoclonus* / diagnosis
  • Myoclonus* / drug therapy
  • Myoclonus* / etiology
  • Syndrome
  • Valproic Acid / therapeutic use

Substances

  • Clonazepam
  • Valproic Acid