Improvement of Post Anoxic Myoclonus with Valproic Acid and Add on Levetiracetam Therapy

Abstract

Myoclonus may be defined as sudden muscle contractions that are brief, involuntary, and shock-like. There are many conditions that can lead to myoclonus including spinal cord injury, stroke and as a side effect of certain drugs. Post hypoxic myoclonus is a recognized entity that develops post successful resuscitation of cardiac arrest and this is known in the literature as Lance Adams Syndrome. Often myoclonus is confused with an underlying seizure disorder. Myoclonic status epilepticus at any time after return of spontaneous circulation (ROSC) is even considered to reliably indicate a poor prognosis. Different treatments have been attempted to manage post hypoxic myoclonus including valproic acid and clonazepam and even Bilateral Pallidal Deep Brain Stimulation. The authors would like to present a case report of a 59-years-old male with chronic post hypoxic myoclonus who was successful treated with a combination medication regime of valproic acid and levetiracetam.