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Treatment of Post-Hypoxic Myoclonus

  • Mark HallettEmail author
Chapter
Part of the Current Clinical Neurology book series (CCNEU)

Abstract

Post-hypoxic myoclonus usually presents as multifocal myoclonus following a hypoxic episode. Typically, it is worse with action, has both positive and negative myoclonus, and leads to significant disability. Clinical neurophysiological studies can be helpful if the diagnosis is in doubt. Treatment with specific anticonvulsants can be helpful, but negative myoclonus is particularly refractory.

Keywords

Hypoxia Anoxia Myoclonus Epilepsy 

Supplementary material

Video 1

At rest, there are myoclonic jerks in the left upper limb which exacerbate during maintenance of posture and especially during movement at which point they are mostly proximal and of large amplitude. The myoclonus, predominantly of the left upper limb, also exacerbates while squeezing the examiner’s fingers. There are myoclonic jerks in the lower limbs that also worsen with movement. When attempting to push back in the wheelchair, the myoclonus increases, particularly in the proximal upper limbs (WMV 60045 kb)

Suggested Reading

  1. Avanzini G, Shibasaki H, Rubboli G, Canafoglia L, Panzica F, Franceschetti S, et al. Neurophysiology of myoclonus and progressive myoclonus epilepsies. Epileptic Disord. 2016;18:11–27.PubMedGoogle Scholar
  2. Fahn S, Jankovic J, Hallett M. Principles and practice of movement disorders. 2nd ed. Philadelphia: Elsevier Saunders; 2011.Google Scholar
  3. Gupta HV, Caviness JN. Post-hypoxic myoclonus: current concepts, neurophysiology, and treatment. Tremor Other Hyperkinet Mov (N Y). 2016;6:409.Google Scholar
  4. Lance JW, Adams RD. The syndrome of intention or action myoclonus as a sequel to hypoxic encephalopathy. Brain. 1963;86:111–36.CrossRefGoogle Scholar
  5. Shibasaki H, Hallett M. Electrophysiological studies of myoclonus. Muscle Nerve. 2005;31:157–74.CrossRefGoogle Scholar
  6. Werhahn KJ, Brown P, Thompson PD, Marsden CD. The clinical features and prognosis of chronic posthypoxic myoclonus. Mov Disord. 1997;12:216–20.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Human Motor Control Section, NINDSBethesdaUSA

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